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Biomedical subjects

O Johnson

Publications and source records attributed to O Johnson.

At least 37 records · Page 2Linked to original sources
PubMed1998

Oesophageal carcinoma in Tikur Anbessa Hospital, Addis Ababa.

A five year review of oesophageal carcinoma in Tikur Anbessa Hospital (TAH), Department of Surgery, Faculty of Medicine is presented. One hundred and forty two patients representing 32.5% of all gastrointestinal and 13.8% of all malignant tumours were seen in the Department during the study period. The age range was 22 to 88 years with a mean of 54 years. There were 54 females and 88 males. Dysphagia, weight loss and anaemia were the significant features in the majority and 40% of patients presented between four and seven months. Squamous cell cancer accounted for 93% of all histologic types. The middle third was the commonest site of tumour formation (49%) while the lower third accounted for 44%. An operability rate of 56% is recorded but only 24% were suitable for oesophagectomy. The post operative mortality was 28%. The commonest causes of death were sepsis secondary to anastomotic leak and pneumonia. Follow up was possible only for three months for eleven patients and seven months for seven patients. The rest could not be traced. It is difficult not to implicate the commonly used dietary ingredients in the causation of this tumour.

Adult↗
PubMed1998

Cushing's syndrome: a ten year experience at Tikur Anbassa Hospital.

A retrospective analysis of Cushing's syndrome from the retrieved records of 24 out of a total of 27 referred cases over a period of 10 years (January 1985-January 1995) showed confirmation in 16 cases. Fourteen (88%) were females, 9 (56%) were in their third decade. Duration of symptoms before admission was one year or less in eleven (69%) patients. Among symptoms weakness, fatigue and weight gain and among signs moon face, truncal obesity and buffalo hump were found in all patients. Amenorrhea occurred in all the women of childbearing age. Basal urinary 17-hydroxycorticoid (17-OHCS) values were elevated in 9/12 patients and low dose dexamethasone suppression test favoured Cushing's syndrome in 8/9 patients. Definitive treatment consisted of bilateral adrenalectomy in 7 and transfrontal pituitary adenomectomy in 3. Two patients declined surgery; 4 patients were lost to follow up before definitive treatment. Two patients who had bilateral adrenalectomy and two who had transfrontal adenomectomy died subsequently while three remained in good health on corticosteroid replacement therapy. Three of the 7 patients who had bilateral adrenalectomy developed Nelson's syndrome. It is concluded that Cushing's disease is the most frequent cause of Cushing's syndrome in our series. The patients presented with the well-known clinical manifestations of hypercortisolism. However, our laboratory facilities require considerable improvement to serve as a reliable adjunct to clinical evaluation. Since Cushing's syndrome, whatever the cause, is eventually fatal if left untreated, surgical intervention is mandatory after confirmation of the cause with appropriate laboratory tests.

Adolescent↗
PubMed1998

Cancer of the lower gastrointestinal tract: a five year experience in Ethiopia.

To provide the pattern and outcome, 131 patients admitted to Tikur Anbessa Hospital, Department of Surgery, between 1992 and 1996 with a diagnosis of lower gastrointestinal tract (colo-anorectal and small bowel) cancer were analysed. Lower gastrointestinal tract cancer accounted for 30% of all gastrointestinal tract malignancies, excluding hepatic cancer, seen in the Department during the study period. The female to male ratio was 1.0:1.8. The mean age was 47.1 +/- 15.7 (range 17-85) years. Among the 131 cases, 52.7% and 16% were under 50 and 30 years of age, respectively. The mean duration of symptoms on admission was 11.2 +/- 8.9 (range 0.2-43) months. The most frequent clinical features included weight loss (93%), pain (86%), rectal bleeding (79%), tenesmus (74%) and anorectal lesion (62%). Adenocarcinoma accounted for 92% of the pathology. Among 94 surgically staged cases, 63 had Dukes' C and D lesions. The most common site of primary tumours was the rectum (61.1%). Ninety per cent of the cases were operable and of these, 63 had resections with curative intent. Twenty patients refused surgery. There were fifteen postoperative hospital-stay deaths. The mean follow up was 5.7 +/- 3.1 (range 0.2-48) months. Cancer of the lower gastointestinal tract seemed to occur in rather younger age and diagnosis was late.

Adolescent↗
PubMed1997

In vivo characterization of sustained-release formulations of human growth hormone.

Long-acting formulations of recombinant human growth hormone (rhGH) were prepared by stabilizing and encapsulating the protein into three different injectable, biodegradable microsphere formulations composed of polymers of lactic and glycolic acid. The formulations were compared in juvenile rhesus monkeys by measuring the serum levels of rhGH and two proteins induced by hGH, insulin-like growth factor-I and IGF binding protein-3 (IGFBP-3) after single s.c. administration. All three formulations, which differed principally in the composition of the polymer, provided sustained elevated levels of all three proteins for several weeks, and the rate of release of rhGH differed among the formulations consistent with the molecular weight of the polymer used. All three formulations induced a higher level of insulin-like growth factor-I and insulin-like growth factor binding protein than was induced by daily injections of the same amount of rhGH in solution. After three monthly injections of one of the formulations, both the rhGH and IGF-I levels remained elevated for nearly 90 days. Immunogenicity of the rhGH released from this formulation, as assessed by the incidence of seroconversion to hGH and the titer of anti-hGH antibody in both the rhesus monkeys and transgenic mice expressing rhGH, was no greater than that of the unencapsulated protein. In addition, the microsphere injection sites appeared normal by macroscopic evaluation between 1 to 2 mo after microsphere administration and by microscopic evaluation between 2 to 3 mo. These results show that serum levels of a therapeutic protein can be sustained for an extended period when encapsulated into different formulations of injectable, biodegradable microspheres.

Animals↗
PubMed1996

Lipoprotein lipase in relation to inflammatory activity in rheumatoid arthritis.

OBJECTIVE: To evaluate the impact of chronic inflammation on lipoprotein lipase (LPL) levels and tri-glyceride metabolism in patients wit rheumatoid arthritis (RA). DESIGN: Plasma levels of LPL activity and mass before and after heparin were determined in post-menopausal women with active RA and in controls. The results were related to lipid levels and inflammatory variables. The LPL activity and mass together with triglyceride levels were also measured before and 6 h after an oral fat load. SETTING: The study was performed on in- and outpatients at a University Rheumatology clinic. The controls came from the same reference area. SUBJECTS: Altogether 17 consecutive postmenopausal female patients with RA and 16 age and sex matched controls were enrolled for the initial determination of LPL. Fifteen of the patients and 15 of the controls agreed to take part in the fat load. Of these, one patient and one control were excluded. MAIN OUTCOME MEASURES: LPL determination: basal levels and post-heparin levels of LPL activity and mass. Correlations between LPL and blood lipids (cholesterol, triglycerides), lipoprotein levels (high density lipoprotein, HDL: low density lipoprotein, LDL), erythrocyte sedimentation rate (ESR) acute phase proteins (orosomucoid, haptoglobin, fibrinogen mass) and cytokines (tumour necrosis factor alpha. TNF-alpha: interleukin 1 beta, IL-1 beta: and interleukin-6. IL-6). Fat tolerance test: LPL activity. mass and triglyceride levels before and 6 h after a per oral fat load. RESULTS: Pre-heparin LPL mass (P < 0.01) and activity (P < 0.01) were significantly lower in the rheumatoid patients. Pre-heparin LPL mass showed no correlation to the lipid levels, but an inverse correlation to several inflammatory parameters: it was significant for orosomucoid (rs = -0.63, P < 0.05) and C-reactive protein (CRP) (rs = -0.54, P < 0.05) and close to significant for haptoglobin (rs = -0.48, P = 0.087) and IL-6 (rs = -0.52, P = 0.061). Six hours after.a lipid load the LPL activity and mass were significantly lower in RA (P < 0.05 and P < 0.01, respectively) but the triglyceride level was not significantly different compared to controls. CONCLUSION: An inverse relationship exists between inflammatory status and pre-heparin LPL mass. Preheparin LPL mass reflects mainly the inactive monomeric fraction of LPL. This has been shown to hinder the uptake of remnant lipoprotein particles through competition with lipoprotein bound dimeric LPL for the LDL receptor-related protein (LRP receptor) on hepatocytes and macrophages in culture. A decrease of the level of monomeric LPL in plasma may thus be beneficial for remnant catabolism. The same mechanism may on the other hand increase macrophage uptake of lipids. This may not affect global lipid metabolism but may be important in driving the atherosclerotic process in the vessel wall.

Aged↗
PubMed1995

Effects of intravenous magnesium sulphate in suspected acute myocardial infarction on acute arrhythmias and long-term outcome.

A total of 252 patients with suspected acute myocardial infarction were included in a double blind study and randomised to 50 mmol magnesium sulfate infusion under 20 h or corresponding placebo. Acute myocardial infarction was verified in 117 patients and 59% of these had concomitant treatment with thrombolysis. One-hundred ninety-four patients had Holter registrations during the first day in the coronary care unit. Intention-to-treat analysis showed an increase in long RR-intervals (> 3 s) in the magnesium treated group (P = 0.006) and a tendency toward a reduction in episodes of ventricular premature complexes in triplets (P = 0.09). During hospital stay and a mean of 22 months follow-up, 23 fatal events occurred in the magnesium allocated group and 31 fatal events among the placebo allocated group (P = 0.1). Mortality rate from cardiac disease was reduced by 54% (95% C.I. 30-99%, P < 0.05). Subgroup analysis on acute myocardial infarction patients showed a 48% mortality risk reduction in the magnesium treated acute myocardial infarction group compared to the placebo treated acute myocardial infarction group (95% C.I. 23-104%, P = 0.06). There was no significant interaction between the effects of magnesium and thrombolytic treatment on total mortality or cardiac events. This study supports the results of other small double blind placebo controlled studies regarding effects of magnesium therapy on mortality in acute myocardial infarction, but are in discordance to the conclusion from the ISIS-4 study. The reasons for these discrepancies cannot be elucidated by our data.

Acute Disease↗
PubMed1995

Vesical calculus in Ethiopian children.

Bladder stone in childhood, otherwise known as endemic bladder stone, is common in parts of Asia and some areas of Africa. This is the first report on bladder stone in children from Ethiopia. A series from the Ethio-Swedish Children's Hospital, Addis Abeba over a ten year period from 1970 to 1980 was retrospectively reviewed. There were 48 cases of stones in the urinary tract of which 94% were bladder or urethral stones. Age, sex, clinical presentation and composition of stones are similar to what is described from countries having a high incidence of this disease. The incidence in this hospital material is low accounting for only 0.25% of admissions.

Child↗
PubMed1994

Renal and ureteral stones, a review based on 104 operated cases from Tikur Anbessa Hospital.

One-hundred-four cases of stones in the upper urinary tract treated by open surgery during 1979 to 1982 at the Tikur Anbessa Hospital have been retrospectively reviewed. Among the patients, 76.5% were between the age of 20 and 40 years and there was a predominance of men with a male to female ratio of 3.7:1. More than 50% of patients presented with a history of illness from one to five years and most of the presenting symptoms and signs were the same as reported by others. Fourteen of the 73 patients tested (19%) had positive urine culture. Conservative operations of pyelolithotomy and ureterolithtomy were made in 71.2% of the patients. Nephrolithotomy was made in 14.3%, partial nephrectomy in 3.8% and nephrectomy in 8.7%. Of the patients 92.3% had an uneventful postoperative course. Mortality was 1.9% and occurred in patients with stone anuria. Chemical analysis of stones from 25 patients showed calciumoxalate in 21, and calciumoxalate with additional phosphate in three patients. One patient had pure uric acid stone.

Adult↗
PubMed1994

Achalasia of the cardia: experience of extramucosal cardiomyotomy during a ten-year period.

Twenty-three cases of achalasia of the cardia admitted to Tikur Anbessa Hospital, Addis Abeba, during a ten-year period, 1976-85, were analyzed for clinical features, means of diagnosis, treatment and results. The common age groups were young adults and middle aged people. There is a definite preponderance of males. Clinical features and diagnosis are discussed in detail. Treatment was exclusively surgical using cardiomyotomy. Of the 23 operated cases, 20 had good or satisfactory results. Three cases developed recurrent dysphagia and gastroesophageal reflux was seen postoperatively in three cases.

Adolescent↗
PubMed1994

Pericardiectomy: experience from Tikur Anbessa Hospital, Addis Abeba, Ethiopia 1975-1993.

Forty-four patients had undergone pericardiectomy in Tikur Anbessa Hospital, Addis Abeba, Ethiopia from 1975 to 1993. Twenty-two of these were analysed for clinical features, etiologic diagnosis and results of treatment. Most patients were young adults with male preponderance. Clinical features coincided with findings in other series of constrictive pericarditis and intractable pericardial effusion. The operative findings at pericardiectomy was a thickened pericardium in all cases, which was adherent to the heart in the majority of cases, and with a large pericardial effusion in four cases. Histology confirmed the presence of tuberculosis in the pericardium in six cases and in the other cases it showed nonspecific chronic inflammation. Sixteen patients were discharged improved and six died after surgery.

Adolescent↗
PubMed1994

Familial polyposis in two Ethiopians.

Cases of familial polyposis coli and Peutz-Jeghers syndrome are reported for the first time in Ethiopia. One case seemed to have the defect as a new mutation in his gene while the other possibly inherited from his father. The one with polyposis coli had transmitted the disease to his offspring. This patient had total colectomy for prophylaxis against a potential carcinoma of the colon.

Adenomatous Polyposis Coli↗
PubMed1993

Effects of magnesium infusion on thrombolytic and non-thrombolytic treated patients with acute myocardial infarction.

UNLABELLED: A total of 109 consecutive patients were included in a double blind, randomized trial of the effect of intravenous magnesium sulfate in acute myocardial infarction. Of these 63% received intravenous fibrinolytic therapy. Twenty four-hour Holter monitoring of heart rhythm was performed during the initial hospital stay. A significant reduction in total cardiac mortality in hospital and during the 9 months follow-up was found in the magnesium treated non-thrombolytic group (P < 0.05). Within this subgroup development of heart failure was decreased (P < 0.01). No effect of magnesium infusion on ventricular arrhythmias was demonstrated, instead we found a greater proportion of patients with short runs of ventricular tachycardias in the magnesium treated non-thrombolytic group (P < 0.05), which may represent an increase in spontaneous reperfusion. CONCLUSION: these results indicates that magnesium infusion may have a beneficial effect on mortality in patients with acute myocardial infarction not receiving thrombolytic therapy, but opposes the view that the benefit is related to an antiarrhythmic effect. No additional effect of magnesium to ongoing fibrinolytic therapy could be demonstrated regarding mortality, reinfarction and heart failure.

Aged↗
PubMed1993

Lipoprotein (a) in a randomly selected 25-64 year old population: the Northern Sweden Monica Study.

Lipoprotein (a) (Lp (a)) was determined in 1527 individuals participating in the Northern Sweden WHO MONICA project for monitoring of cardiovascular risk factors in the general population. Subjects were randomly selected and stratified according to sex and age. A weak but significant relation between Lp (a) and increasing age was found in both sexes (p < 0.01). Menopausal status was the strongest independent predictor of Lp (a) level in women (p = 0.010). Fibrinogen was independently related to Lp (a) in both men and women (p < 0.05). An inverse relation between waist-to-hip ratio and Lp (a) was found in men (p < 0.01). Hypertensive subjects treated with diuretics had significantly higher Lp (a) than hypertensives on other agents (p < 0.05). Only a minor proportion of Lp (a) variance could be explained by lifestyle factors, which supports the contention that genetic factors primarily control Lp(a) level.

Adult↗
PubMed1992

Changes in Lp(a) lipoprotein levels during the treatment of hypercholesterolaemia with simvastatin.

Thirty-six patients with total serum cholesterol levels above 6.5 mmol/l and Lipoprotein(a) levels above 100 mg.l-1 were evaluated in a 24 week double-blind, placebo controlled, cross-over study to assess the possible changes in Lp(a) during treatment with the HMG CoA reductase inhibitor simvastatin. The median plasma Lp(a) increased from 359 to 464 mg.l-1 during simvastin treatment as compared to placebo (not significant). Individual changes in Lp(a) varied. In a multivariate linear regression analysis the individual change in Lp(a) was correlated with the baseline Lp(a) (r = 0.64), the change in serum triglycerides (r = 0.48) and the baseline apolipoprotein B (r = 0.36). Differences between the Lp(a) phenotypes may explain some of the varied Lp(a) responses. It appears that the effect of simvastatin on the Lp(a) level in individuals is usually insignificant, but in patients with a high Lp(a) simvastatin may further increase it.

Adult↗
PubMed1992

Lipoprotein(a) and acute-phase proteins in acute myocardial infarction.

Lipoprotein(a) (Lp(a)) and the acute-phase proteins, orosomucoid, haptoglobin and alpha 1-antitrypsin, were studied in 32 patients with acute myocardial infarction. Samples were taken at admission and, after fasting overnight, on the following 6 days. In a subgroup of 21 patients total serum cholesterol, high-density lipoprotein (HDL) cholesterol and triglycerides were also estimated. In a linear regression model a significant relation between the relative values of Lp(a) and the time in days was obtained (p = 0.001). Compared with the acute-phase proteins, however, Lp(a) showed a weak increase and the individual responses were very variable. There were no correlations between the individual changes in Lp(a) and the changes in the acute-phase proteins, but Lp(a) changes correlated significantly with the changes in total cholesterol and low-density lipoprotein (LDL) cholesterol. It is suggested that the Lp(a) reaction in myocardial infarction is linked to the reaction of the lipoproteins. There may also be several clinical conditions, including different medications, which influence the Lp(a) level.

Acute-Phase Proteins↗
PubMed1991

von Willebrand factor in plasma: a novel risk factor for recurrent myocardial infarction and death.

OBJECTIVE: To evaluate as predictors of reinfarction and mortality tissue plasminogen activator antigen and activity before and after venous occlusion, plasminogen activator inhibitor, von Willebrand factor, and established risk factors. DESIGN: Prospective study with a mean observation time of 4.9 years. SETTING: Secondary referral centre, the Department of Internal Medicine, University Hospital of Umeå. PATIENTS: 123 consecutive survivors of myocardial infarction under the age of 70 years. MAIN OUTCOME MEASURES: Reinfarction and deaths from all causes. RESULTS: 23 patients died and 36 patients had at least one reinfarction. High concentrations of von Willebrand factor were independently associated with both reinfarction and mortality. A history of angina at entry into the study was also independently associated with reinfarction and mortality. Hypertension was independently associated with mortality but not with reinfarction. None of the fibrinolytic or lipid variables was associated with reinfarction or death. CONCLUSION: A high concentration of von Willebrand factor was a novel index of increased risk for reinfarction and mortality in survivors of myocardial infarction.

Adult↗
PubMed1991

Influence of dietary fat, cholesterol and energy on serum lipids at vigorous physical exercise.

Seven healthy male volunteers participated in four different heavy cross-country ski trips in the mountains, 1 year apart, wearing a back-pack weighing 30 kg. Each trip lasted for 8 days covering a total distance of 160 km. Serum triglycerides and lipoprotein cholesterol were measured before and after the trip. The different experiments were carried out with the same participants and under the same conditions, but with a varying diet composition. With the four different diets used, a standard diet (3800 kcal day-1, 26% fat, 260 mg cholesterol day-1), a low-energy diet (2300 kcal day-1, 21% fat, 110 mg cholesterol day-1, a high-fat-high-cholesterol diet (3800 kcal day-1, 52% fat, 480 mg cholesterol day-1) and a high-cholesterol diet (3800 kcal day-1, 29% fat, 410 mg cholesterol day-1), a decrease in very low-density lipoprotein-low-density lipoprotein (VLDL-LDL) fraction by 38%, 50%, 41%, and 54%, respectively, was obtained. No significant increase in high-density lipoprotein (HDL) cholesterol was found in the experiments with the standard diet and the low-energy diet, but in the high-fat-high-cholesterol diet experiment the HDL cholesterol increased by 19% and the ratio HDL cholesterol:total cholesterol from 0.327 to 0.490. With the high-cholesterol diet an increase in HDL cholesterol of about the same extent was obtained. In all experiments the serum triglycerides decreased by more than 30% and no significant difference for the different diets was obtained.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗