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Biomedical subjects

O A Haugen

Publications and source records attributed to O A Haugen.

At least 19 recordsLinked to original sources
PubMed2001

[Forensic medical aspects of intracranial hemorrhage].

BACKGROUND: Intracranial haemorrhage may be due to pathological processes or trauma even in the absence of a fracture. Since the circumstances surrounding death in such cases are often obscure, the police are notified and a forensic autopsy is performed. MATERIAL AND METHODS: We have retrospectively analysed 116 cases (66 males and 50 females) of intracranial haemorrhages without a concomitant fracture occurring in a series of 4,040 forensic autopsies. RESULT: Intracerebral haemorrhage was most frequently encountered (46%), while subarachnoidal haemorrhage occurred in 38 cases (32.8%), of which only 27 (71%) had aneurysms. In two cases, traumatic subarachnoidal haemorrhage occurred after a fight. Subdural haematomas were found in 24 cases (21%); they were significantly more frequent among men than among women. Intracerebral haemorrhage was often associated with cardiac hypertrophy, while subdural haematomas were strongly associated with alcohol abuse and falls. Intracerebral bleeding in the younger age group was related to arteriovenous malformations, abuse of heroin or amphetamine. In the majority of cases, the haemorrhage occurred at home. In 21 cases there was information about accidents, mainly falls. Eight cases were later brought to court and the perpetrator charged with manslaughter or murder. Hospital admission occurred in 18% of the cases; only half of the patients underwent surgery and died from cerebral complications. INTERPRETATION: This investigation underlines the importance of performing a forensic autopsy in fatalities with head injury or intracranial haemorrhage in order to specify the type of bleeding and possible aetiological factors involved.

Accidents↗
PubMed1999

[Death behind the wheel].

In Norway traffic accidents are increasing with 12,000 casualties and more than 300 deaths every year. This retrospective study is based on 230 forensic reports of drivers involved in fatal car accidents. There was a male preponderance (85%) and the average age was 42.5 years. In 78% of the cases the cause of death was a direct consequence of the accident, multitraumas and head injuries representing the majority, while drowning occurred in 11% of the cases. Death from natural causes was established in 27 cases; the main cause was acute cardiovascular disease. These accidents occurred at low speed. In 17 cases (7%) serious cardiac disease, CNS pathology or diabetic complications contributed significantly to the accidents that inflicted greater injuries on the vehicles and occupants. Raised blood alcohol levels were found in 21% of the drivers. Hepatic steatosis was observed in 16% of all drivers, most of whom were not under the influence of alcohol. Suicide was recorded in six cases (2.5%). This study shows that in addition to drunkenness, organic disease, especially cardiovascular disease and alcoholic liver disease represent risk factors of major importance in fatal road accidents.

Accidents, Traffic↗
PubMed1999

[Telepathology in Mid-Norway].

Telepathology can provide frozen section service to hospitals without a pathology service of their own. Using a dynamic-robotic system with 6 ISDN B-channels (Telemed A200, AM Elektronikk A/S, Oslo, Norway), the pathologists at the University Hospital in Trondheim, Norway during a three-year period from 1995 successfully performed 116 diagnostic sessions for two rural Norwegian hospitals. In 90% of the cases a diagnosis was provided. There was no false positive diagnosis and only 3% false negative cases without clinical consequence. Deferred cases (10%) were mainly due to poor quality of the frozen sections and a conservative attitude among the pathologists. It is concluded that the diagnostic accuracy is good, but for safety reasons telepathology should be offered on a regular basis, so that the skills of the technicians and pathologists involved are kept up. In Mid-Norway, five more hospitals will be included in a telemedicine network comprising eight hospitals in the region.

Attitude of Health Personnel↗
PubMed1999

Human papillomavirus (HPV) in high-grade cervical intraepithelial neoplasia (CIN) detected by morphology and polymerase chain reaction (PCR)-- a cytohistologic correlation of 277 cases treated by laser conization.

The aims of this study were to evaluate the cytohistologic correlation in women treated for high-grade lesions of the cervix uteri (HG CIN), to assess the distribution of HPV features and finally to test the validity of the morphological criteria of HPV infection. The smears and biopsy specimens from 277 women treated for HG CIN by laser conization were re-evaluated blindly. Tissue blocks (n = 188) and 52 archival smears were examined for HPV DNA using PCR. HPV changes were detected with equal frequency in the smears and biopsy specimens by light microscopy; 63% and 65%, respectively. The prevalence of HPV DNA in biopsies was 88% and in archival smears 85%; agreement was found in 89% of the cases. Using PCR as the gold standard, we found a sensitivity of 63% for cytology and 70% for histology; the specificity was 41% and 37%, respectively. The positive predictive value was > 80%, but the negative predictive value was < 20%. Our study confirms that HPV features are frequently associated with HG CIN and that morphology is a non-specific method of identifying HPV infection and should be followed by PCR, also allowing detection of oncogenic HPV types and latent infections.

Conization↗
PubMed1999

Expression of p53, MDM2, and p21 proteins in high-grade cervical intraepithelial neoplasia and relationship to human papillomavirus infection.

The relationship between human papillomavirus (HPV) infection and cell cycle regulators p53, MDM2, and p21 in cervical intraepithelial neoplasia (CIN) has not been investigated. p53, MDM2, and p21 immunoreactivity were analyzed with respect to HPV DNA status in high-grade CIN (CIN II-III). Formalin-fixed, paraffin-embedded tissue sections from 169 biopsy specimens with high-grade CIN were examined for HPV DNA by polymerase chain reaction with the L1 and E1 consensus primers Gp5+/6+ and CpI/CpIIG. HPV-positive specimens were typed with the E6 type-specific primers for HPV 16 and 18. The biopsy specimens were stained with the monoclonal antibodies p53, MDM2, and p21. The interpretation of nuclear staining was regarded as focal (< 5%), regional (5% to 50%), or diffuse (> 50%). HPV DNA was found in 156 cases (92%); 122 (78%) were positive for HPV 16, 18, or both. Immunohistochemically, p53 was detected in 50 specimens (30%); nuclear staining was mainly focal. Focal nuclear staining for MDM2 was found in 6 specimens (4%), and regional and diffuse nuclear staining for p21 was present in 137 (81%). Significant correlation was found only between p53 and MDM2 immunoreactivity. These results indicate that there is no correlation between HPV status and expression of the cell cycle regulators p53, MDM2, and p21. Inactivation of p21 and p53 protein may be important, and MDM2 abnormalities seem to play a minor role in the development of high-grade CIN.

Cyclin-Dependent Kinase Inhibitor p21↗
PubMed1999

Association between the HLA DQB1*0301 gene and human papillomavirus infection in high-grade cervical intraepithelial neoplasia.

This study describes the distribution of DQB1genes in Norwegian women treated for high-grade cervical intraepithelial neoplasia (CIN). Formalin-fixed, paraffin-embedded tissue sections from 170 biopsy specimens with diagnoses of CIN II (n = 54) or CIN III (n = 116) were DQB1-typed using allele-specific polymerase chain reaction. The follow-up period for cases was 13 to 15 years. The control material comprised blood samples and endocervical brushes from 213 women without CIN. Both cases and controls had previously been human papillomavirus (HPV)-typed. The DQB1*0301 allele was overrepresented among cases compared with controls (odds ratio [OR] = 1.8). Presence of CIN was related to HPV infection, and HPV 16 positivity was significantly associated with the presence of DQB1*0301 (OR 1.8). The DQBI*0301 allele was significantly more prevalent in CIN III than in CIN II cases. The lesions in two women recurred in the follow-up period, one of whom was carrying the DQB1*0301 allele. Women carrying the HLA-DQB1*0301 allele have an increased risk of developing CIN when infected by HPV 16, although there was not an increased frequency of recurrent disease among women carrying this allele.

Adult↗
PubMed1998

[Still a no when it comes to active euthanasia].

While there has been a growing acceptance among the general public in Norway that euthanasia and physician assisted suicide should be made legal, the Norwegian Medical Association still strongly opposes such acts. A recent survey at the University Hospital in Trondheim confirms that Norwegian physicians in general have a very restrictive attitude towards euthanasia. Among 483 physicians (response rate 72.8%), only 17.6% were in favour of physicians actively contributing to shortening the life of a patient. However, 36% of the surgeons and gynecologists had a more liberal view, although only 16.5% would personally assist in such acts. None of 69 oncologists, pediatricians, neurologists or neurosurgeons were willing to perform euthanasia. Should euthanasia be established as a legal right, a considerable number of physicians would probably insist on having the right to abstain.

Attitude of Health Personnel↗
PubMed1998

[Low grade non-Hodgkin lymphoma of B-cell type. What is the benefit of polymerase chain reaction and immunohistochemical examination?].

Subclassification of malignant non-Hodgkin's lymphoma is important to be able to choose the right treatment. However, this subclassification can be difficult, and immunohistochemistry and polymerase chain reaction are used to improve diagnostic safety. We have investigated the value of immunohistochemistry and polymerase chain reaction in the subclassification of 49 low grade non-Hodgkin's lymphomas of B-cell type. Immunohistochemistry showed B-cell phenotype in all biopsies, and 23 (85%) of 27 follicular lymphomas showed positive reaction for bcl-2 antibodies in follicles. Polymerase chain reaction demonstrated a monoclonal pattern for IgH in 36 (73%) of 49 biopsies, and 10 (37%) of 27 follicular lymphomas demonstrated translocation (14; 18). Immunohistochemistry and polymerase chain reaction contributed to subclassification or confirmation of the diagnosis of 46 (94%) of 49 biopsies. Our conclusion is that immunohistochemistry and polymerase chain reaction have a natural place in the diagnosis of lymphomas.

Adult↗
PubMed1997

Use of neuroendocrine serum markers in the follow-up of patients with cancer of the prostate.

Neuroendocrine (NE) differentiation of prostatic adenocarcinomas has received increasing attention in recent years as a result of possible implications on prognosis and therapy. The incidence of NE cells in tumors has been reported from 10% up to 100%. Several studies have shown chromogranin A (CgA) to be the most reliable serum marker of NE differentiation. We have followed 22 patients with prostatic adenocarcinoma over a 2-year period. The patients underwent a palliative transurethral resection of the prostate (TURP) because of urinary outflow obstruction. The prostatic tissue specimens were stained immunohistochemically using antibodies against CgA, chromogranin B (CgB), neuron-specific enolase (NSE), thyroid-stimulating hormone (TSH), serotonin, and somatostatin. In addition, each specimen was stained with hematoxylin & eosin (H & E), and saffran for tumor grading. Blood samples were taken preoperatively and after 1, 3, 6, and 24 months. The serum values of CgA, CgB, pancreastatin (Pst), NSE, and prostate-specific antigen (PSA) were determined from each sample. Carcinomas with groups of CgA-positive cells had higher serum levels of CgA compared to carcinomas with no or only scattered CgA-positive NE cells. During the 2-year period, there were no statistical significant variations in serum levels of CgA, NSE, Pst, and PSA. However, there was a significant increase in serum levels of CgB during the same period, P = 0.002, possibly due to an increase in number of NE cells in tumor or to a relative increase in production of CgB in the NE cells.

Adult↗
PubMed1997

Treatment of pre-invasive conditions during opportunistic screening and its effectiveness on cervical cancer incidence in one Norwegian county.

Norway had until recently no organized screening programme for cervical cancer, but opportunistic screening was common. This study focuses on the effectiveness of treatment of pre-malignant cervical conditions (CIN III) on cervical-cancer incidence in the county of Sør-Trøndelag in Norway, prior to the introduction of organized mass screening. The study is based on cervical-cancer incidence rates during the years 1965-92 and treatment data for CIN III. The expected number of cervical-cancer cases prevented due to early intervention was expressed in a regression model with 2 unknown parameters: the probability, p, of cancer development in case of CIN III, and the time lag, t, between treatment and when clinical cancer would otherwise have been diagnosed. The estimated probability that a patient treated for CIN III would have developed cervical cancer if not treated was found to be approximately 20%, and the mean time delay was around 16 years. In the last period of study (1988-92), the incidence was reduced by nearly 40% of what would have been expected without early intervention. Based on equal treatment rates as in 1990, parameter estimates were used to predict future incidence reduction. Maximum effectiveness will be achieved around the year 2005, with a nearly 70% reduction. Opportunistic screening and treatment of CIN III seems to have had considerable influence on cervical-cancer incidence. The costs, however, are substantial over-treatment, since our results indicate that 4 of 5 women treated for CIN III would not progress into the invasive state.

Adult↗
PubMed1997

Neuroendocrine differentiation in carcinomas of the prostate: do neuroendocrine serum markers reflect immunohistochemical findings?

The aim of the present study was to examine the correlation between the immunohistochemical findings and the serum markers for neuroendocrine (NE) cells in patients with carcinoma of the prostate. Preoperative serum values of chromogranin A (CgA), chromogranin B (CgB), pancreastatin (Pst), neuron-specific enolase (NSE), and prostatic specific antigen (PSA) were determined in 22 patients. The tissue specimens were obtained by a palliative transurethral resection of the prostate (TURP) because of urinary outflow obstruction. Immunohistochemistry was performed by using antibodies against CgA, CgB, NSE,.serotonin, thyroid-stimulating hormone (TSH), and somatostatin. Tumor cells with NE differentiation were found in 91% of the cases. No patient had elevated serum values of NSE, despite the presence of NSE-positive tumor cells in 77% of the tumors. Neither did CgB in serum correlate with the immunohistochemical findings. Elevated serum values of CgA were found in 59% of patients. A positive correlation between the number of CgA-staining cells and the serum values of CgA was found, as seven out of eight patients with groups of CgA-positive tumor cells had elevated serum values of CgA. We conclude that CgA, in contrast to NSE, CgB, and Pst, seems to be a useful serum marker in predicting the extent of NE differentiation in prostatic tumors.

Aged↗
PubMed1997

Comparison of light microscopy, in situ hybridization and polymerase chain reaction for detection of human papillomavirus in histological tissue of cervical intraepithelial neoplasia.

The aims of the study were to estimate the prevalence of HPV infection in patients treated for high grade lesions of the cervix uteri (HG CIN), and to evaluate the validity of the histological criteria used for detection of HPV infection. The study comprised 203 women treated for HG CIN by laser conization. Forty-three preoperative biopsies and 160 cone specimens were examined for HPV infection using light microscopy (LM), in situ hybridization (ISH), and polymerase chain reaction (PCR). ISH was performed using commercial biotinylated probes for HPV types 6/11, 16/18, and 31/33/35 (Vira-Type In Situ Kits, Digene Diagnostics, Silver Spring, MD). HPV-PCR was performed with the L1 consensus primers Gp5+/6+. The prevalence of HPV detected by LM was 70%; by ISH 48% and by PCR 83%. Using PCR as the gold standard, LM had a sensitivity of 0.71 and specificity of 0.41. The corresponding results for ISH were 0.51 and 0.65, respectively. The positive predictive value for both tests reached over 80%, but the negative predictive value was less than 25%. This study demonstrates that morphology is an unspecific method of identifying HPV infections. LM identification of HPV infections has no clinical implications. Our analyses comparing test performances of LM, ISH and PCR show that PCR is the superior method.

Adult↗
PubMed1996

Long-term effects of inhaled nicotine.

Tobacco smoking has been reported to be associated with increased risk of cardiovascular disease and cancer, particularly of the lungs. In spite of extensive research on the health effects of tobacco smoking, the substances in tobacco smoke exerting these negative health effects are not completely known. Nicotine is the substance giving the subjective pleasure of smoking as well as inducing addiction. For the first time we report the effect on the rat of long-term (two years) inhalation of nicotine. The rats breathed in a chamber with nicotine at a concentration giving twice the plasma concentration found in heavy smokers. Nicotine was given for 20 h a day, five days a week during a two-year period. We could not find any increase in mortality, in atherosclerosis or frequency of tumors in these rats compared with controls. Particularly, there was no microscopic or macroscopic lung tumors nor any increase in pulmonary neuroendocrine cells. Throughout the study, however, the body weight of the nicotine exposed rats was reduced as compared with controls. In conclusion, our study does not indicate any harmful effect of nicotine when given in its pure form by inhalation.

Administration, Inhalation↗