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Biomedical subjects

P E Jørgensen

Publications and source records attributed to P E Jørgensen.

At least 19 recordsLinked to original sources
PubMed2005

Procalcitonin as a marker of postoperative complications.

OBJECTIVE: Procalcitonin (PCT) is a 116 amino acid peptide that functions as a pro-hormone for calcitonin in the C cells of the thyroid gland. Large quantities of intact PCT are present in the blood of patients with sepsis, particularly when organ dysfunction occurs. PCT has been proposed as an early marker of postoperative complications. The aim of this study was to examine the diagnostic accuracy of PCT as a marker of postoperative complications by systematically reviewing the existing literature. MATERIAL AND METHODS: The databases PubMed, Embase and the Cochrane Library were searched to find studies on the diagnostic accuracy of PCT in the postoperative phase. Primary studies were retrieved using specific inclusion and exclusion criteria. RESULTS: A total of nine studies were included. These studies were heterogeneous regarding the spectrum of patients, complications, design and methodological quality according to QUADAS (quality assessment of studies of diagnostic accuracy). This could explain the marked variation in diagnostic accuracy. Considering all types of complications the sensitivity ranged from 37% to 100% and the specificity from 70% to 100%. On examining the infectious complications separately, it was found that the sensitivity ranged from 70% to 86% and the specificity from 45% to 98%. CONCLUSIONS: Owing to a pronounced heterogeneity among the existing studies, the diagnostic accuracy of PCT as a marker for postoperative complications is not yet sufficiently clarified.

Biomarkers↗
PubMed2005

Implementing the water framework directive in Bulgaria: Integrated river basin management on the Black Sea coast.

EC member states and candidate countries are in the process of implementing the requirements of the EC Water Framework Directive 2000/60, which came into force on 22 December 2000. At the core of the Directive is an integrated approach for sustainable water management in river basin districts. The overall objective is to reach good water status for all waters by the year 2015. The challenges for countries implementing the Directive are substantial not least for the River Basin Management Authorities who will be the implementing unit at the regional level. The Black Sea River Basin Directorate in Varna is one of four Directorates established in Bulgaria in 2002 in accordance with the Bulgarian Water Act and is the regional operational unit under the Ministry of Environment and Water for the Black Sea Basin catchment area. The catchment area covers 20% of Bulgaria and 100% of the Bulgarian Black Sea coast. Current implementation activities in the Black Sea Basin Directorate and also at the national level are supported by the Danish EPA through its DANCEE programme in collaboration with the Ministry of Environment and Water. This paper highlights the main activities and outputs of the technical and institutional undertakings in the Black Sea Basin Directorate focusing on the preparation of the River Basin Overview by Dec. 2004.

Bulgaria↗
PubMed2001

[Evidence-based use of clinical biochemistry].

Evidence-based use of clinical biochemistry integrates into clinical decision-making the best research evidence with the clinical expertise of the physician and the expectations and concerns of the patient. The best research evidence for the clinical use of a biochemical test should be appraised in close collaboration between clinicians and specialists in clinical biochemistry, as familiarity with both the clinical problem and the analytical performance of the test is necessary. At present, it is difficult to ensure an evidence-based use of biochemical tests. More and methodologically better studies of the clinical value of biochemical tests are needed, and methods should be developed that make it possible to assess the results of such studies by systematic reviews and meta-analyses. Clinical biochemistry is an interdisciplinary specialty, and papers on the clinical value of biochemical tests are published in a vast number of journals of different clinical specialties as well as those of clinical biochemistry. It is thus almost impossible to keep abreast of the subject. The establishment of a system for literature surveillance focusing on methodologically sound studies of the clinical value of biochemical tests would be advantageous. Lastly, training and education on how to find and assess the existing evidence for the clinical use of biochemical tests are needed.

Biochemistry↗
PubMed2001

Early urinary changes in Tamm-Horsfall protein and epidermal growth factor in diabetic children.

Both glomerular and tubular markers have been used to follow diabetic nephropathy. However, neither albumin nor proximal tubular markers have proven useful in prepubertal diabetes. Hence we studied two markers derived from the distal tubular cells, Tamm-Horsfall protein (THP) and epidermal growth factor (EGF). The urinary excretion of THP and EGF was examined in samples obtained during the first 20 days and 1 year after diagnosis of diabetes in children aged 4-15 years. Fourteen children without and 18 with ketonuria were examined, and 17 age-matched healthy children participated as controls. The excretion rate of EGF was increased at diagnosis, while that of THP was not. After 20 days of treatment the excretion of EGF had normalized, while the excretion of THP was decreased. Similar results were obtained after 1 year. In conclusion, in spite of good metabolic control a reduced excretion of THP persisted for at least 1 year after the diagnosis of diabetes. Whether the finding of reduced excretion of THP has any biological significance awaits further study.

Adolescent↗
PubMed2001

Serum hepatocyte growth factor levels in patients with chronic renal disease--effect of GFR and pathogenesis.

UNLABELLED: Hepatocyte growth factor (HGF) is a growth-promoting peptide that appears to act in a renotropic and nephroprotective manner during acute renal damage. Recent studies suggest that HGF is also of importance in chronic renal diseases. The serum HGF level is correlated with serum creatinine, and it has been suggested that glomerular and tubular diseases affect serum HGF differently. In the present study. levels of serum HGF were determined and correlated to glomerular filtration rate (GFR) in 118 patients with various chronic renal diseases. GFR was determined by 99mTc-DTPA clearance, and the GFR values were evenly distributed in the interval 5-155 mL/min/1.73 m2. Serum HGF levels increased slightly with decreasing GFR: the Pearson correlation coefficient being 0.49 (p<0.0001). In 21 additional patients with end-stage renal disease treated with continuous ambulatory peritoneal dialysis, there was a more marked increase in the serum levels of HGF. The effect of glomerular and tubular diseases on serum HGF was examined by comparing the HGF levels in two groups of patients with similar GFR values: 57 patients with mainly glomerular disorders (diabetic nephropathy with micro- or macroalbuminuria or glomerulonephritis) and 14 patients with mainly tubular disorders (polycystic kidney disease). There was no significant difference between the HGF levels of the two groups (p=0.30). IN CONCLUSION: Serum HGF levels are correlated with GFR (for GFR > or = 5 mL/min/1.73 m2) in patients with chronic renal diseases, and glomerular and tubular disorders seem to affect the HGF level similarly.

Adult↗
PubMed2000

Determination of porphobilinogen deaminase activity in human erythrocytes: pertinent factors in obtaining optimal conditions for measurements.

Determination of porphobilinogen deaminase (PBGD; EC 4.3.1.8) activity in erythrocytes can contribute to the identification of patients suspected of acute intermittent porphyria. PBGD catalyses the polymerization of four molecules of porphobilinogen (PBG) to the highly unstable 1-hydroxymethylbilane. The 1-hydroxymethylbilane is transformed into uroporphyrinogen III by uroporphyrinogen III synthase. When this enzyme is inactivated, 1-hydroxymethylbilane cyclizes non-enzymatically to uroporphyrinogen I, which can be oxidized to uroporphyrin I. PBGD activity can be measured by quantitation of uroporphyrin I formed from PBG under conditions where this is the only end product. The purpose of the present study was to define the optimal conditions for quantitating PBGD activity in human erythrocytes. The preanalytical factors examined were: anticoagulants and methods for disruption of the erythrocytes. The analytical factors examined were: duration of preincubation, reaction time, reaction temperature, pH, ionic strength and conditions for the oxidation of uroporphyrinogen I to uroporphyrin I. Based on the results, we propose an optimized method for determination of PBGD activity in erythrocytes.

Adult↗
PubMed2000

Activity and immunohistochemical localization of porphobilinogen deaminase in rat tissues.

Porphobilinogen deaminase (PBGD) is an enzyme involved in the synthesis of heme. Acute intermittent porphyria (AIP) is an inherited disease resulting from a reduced activity of PBGD. The symptoms seem to be due to a neurological dysfunction. Attacks of AIP are often provoked by conditions where the PBGD activity becomes insufficient as a result of an increased synthesis of heme in the liver. How this affects the nervous tissue is still unknown. It may well be that a reduced activity of PBGD in other tissues than the liver is of importance too. The aim of the present study was to examine the activity and the immunohistochemical localization of PBGD in the following tissues of wistar female rats: brain, heart, submandibular gland, liver, kidney, pancreas, ovary, stomach, duodenum, jejunum, ileum, colon and musculature. The PBGD activity varied considerably among the tissues. It was highest in the liver, 14 pkat/g, and lowest in the jejunum, 0.7 pkat/g. The immunohistochemical localization of PBGD was studied by antibodies raised against a 40 amino acid synthetic peptide that corresponds to a segment in the C-terminal part of PBGD. The study demonstrated that the PBGD immunoreactivity was not evenly distributed among the various cell types in a given tissue. Immunohistochemical reactions were pronounced in Kupffer cells in the liver, in smooth muscle cells of arteries and arterioles, in distal and collecting tubules in the kidney, in nerve axons in the brain and in ganglionic cells in the intestine. Especially, the immunohistochemical reaction in nerve cells is notable considering the nervous dysfunction in AIP.

Amino Acid Sequence↗
PubMed2000

A meta-analysis of cerebrovascular disease and hyperhomocysteinaemia.

Hyperhomocysteinaemia has been identified as a risk factor for stroke and cerebrovascular disease in several studies. To evaluate the evidence we performed a meta-analysis. We found 21 studies searching Medline from 1966-July 1999 using the key words homocysteine, homocystine and cerebrovascular disease or stroke combined with a search of Embase, Science Citation Index and Biological Abstract. In 17 of these studies the populations were comparable. The studies were divided into two groups, cross-sectional studies and longitudinal studies where a pre-insult plasma or serum total homocysteine was used. The reports on 8 cross-sectional and 4 longitudinal studies gave data on the mean and standard deviations of plasma or serum homocysteine for both cases and controls, and these studies were included in the meta-analysis. The results of the 5 excluded studies all pointed to a positive relationship between hyperhomocysteinaemia and cerebrovascular disease. For each study, the expected fractions of the cases with total homocysteine higher than the 95-percentile for the controls were calculated, using the means and standard deviations, assuming a log-normal distribution, and the odds-ratios for disease with total homocysteine above the 95-percentile were computed. The overall weighted odds-ratio for disease with a concentration of homocysteine in plasma or serum above the 95-percentile (95% confidence interval) for the cross-sectional studies was 4.12 (2.94-5.77), for the longitudinal studies 3.74 (2.53-5.54), and for all 12 studies 3.97 (3.07-5.12). In conclusion, the results support the case for a strong relation between hyperhomocysteinaemia and cerebrovascular disease.

Cerebrovascular Disorders↗
PubMed1999

Expression of transforming growth factor alpha and epidermal growth factor receptor in human bladder cancer.

We analysed the expression of epidermal growth factor receptor (EGFr) and transforming growth factor alpha (TGF-alpha) in human bladder tumours. Tumour biopsies were obtained from 54 patients with primary bladder cancer (18 stage T1 and 36 stage T2-4). The protein and mRNA expression of EGFr and TGF-alpha were quantified by ELISA and competitive RT-PCR, respectively. The EGFr protein level was significantly increased in T2-4 tumours (0.44 x 10(-11); 0.0-27.5 x 10(-11) mol/g) compared with T1 tumours (0.0; 0.0-2.0 x 10(-11) mol/g) (median; range; 2p<0.01). The EGFr protein and mRNA level correlated (Spearman r=0.45, 2p<0.005, n=40). Co-expression of TGF-alpha protein and EGFr protein was significantly associated with muscle invasive tumours (T2-4) (chi-squared=7.9, df=3, p<0.05) and the TGF-alpha protein level correlated significantly with EGFr protein expression (Spearman r=0.56, 2p<0.0001, n=54). While tumour stage correlated with survival, no correlation was observed between survival and the expression of EGFr and/or TGF-alpha. In conclusion, human bladder tumours express both EGFr and TGF-alpha. The expression of EGFr and TGF-alpha are closely correlated, and the expression of EGFr and co-expression of EGFr and TGF-alpha correlate with tumour stage.

Enzyme-Linked Immunosorbent Assay↗
PubMed1999

Adsorption of EGF receptor ligands to test tubes--a factor with implications for studies on the potency of these peptides.

Studies on the relative potency of ligands for the epidermal growth factor receptor are usually performed with highly purified ligand specimens. However, adsorption of ligands to glass and plastic surfaces may affect the results by reducing the ligand concentration in an unpredictable way. The aim of this study was to examine the adsorption of four epidermal growth factor (EGF) receptor ligands, EGF, transforming growth factor alpha (TGF-alpha), heparin binding-EGF (HB-EGF) and betacellulin, to commonly used test tubes of polyethylene, polystyrene and glass, respectively. The ligands were kept in a sodium phosphate buffer, both with and without 0.1% human albumin as carrier protein. Adsorption was examined after 20 minutes at room temperature as well as after overnight storage at 4 degrees C. The ligands were quantitated by ELISAs. In the buffer not containing 0.1% human albumin there was a marked adsorption, which differed both among the ligands and among the test tubes. After 20 minutes the ligand concentrations were reduced to 33-73% in polyethylene tubes, to 15-46% in polystyrene tubes and to 12-29% in glass tubes. The adsorption was even more pronounced after storage overnight. The use of 0.1% human albumin in the buffer solved the problem in polyethylene and polystyrene tubes, but not in glass tubes. The results demonstrate that adsorption to surfaces can be a significant problem for EGF receptor ligands and emphasize the need for controlling the growth factor concentration in the final experimental setting.

Adsorption↗
PubMed1999

Adrenergic blockade in diabetic and uninephrectomized rats: effects on renal size and on renal and urinary contents of epidermal growth factor.

The present study reports on the effects of adrenergic blocking agents on the renal growth and on the renal content and urinary excretion of epidermal growth factor (EGF) in streptozotocin-induced diabetic or uninephrectomized rats. Diabetic and uninephrectomized rats were allocated to groups treated with either saline or adrenergic antagonists and compared to controls and sham-operated controls, respectively. 24-hour urine samples were obtained on days 7, 14, and 21 and renal tissue samples on day 21. The 24-hour urinary excretion of EGF from controls and saline-treated diabetic rats was comparable. In adrenergic antagonist treated diabetic rats, it was reduced by at least 40% throughout the study period. Uninephrectomy caused a 50% reduction in the urinary excretion of EGF. This was not influenced by treatment with an adrenergic antagonist. After 3 weeks, saline-treated diabetic rats had an increase of 33% in kidney weight when compared to controls. The adrenergic antagonist treated diabetic groups had a significantly lower increase of 15%. Postnephrectomized renal growth was not affected by adrenergic antagonists. The total renal content of EGF was comparable in the saline-treated diabetic group and the control group, but was reduced by approximately 50% in the kidneys from the adrenergic antagonist treated diabetic groups. Renal EGF mRNA levels were also reduced in adrenergic antagonist treated diabetic rats. In contrast to diabetes, the renal growth following nephrectomy was not affected by adrenergic blocking agents. These results provide evidence for fundamental differences between diabetes-related renal growth and that observed in compensation to nephrectomy and suggest a connection between adrenergic activity, renal growth, and EGF in diabetes.

Adrenergic alpha-Antagonists↗
PubMed1998

Time-dependent changes of levels of endogenous epidermal growth factor in submandibular glands, in kidneys, and in urine in rats during systemic treatment with EGF.

BACKGROUND: Exogenous EGF influences the levels of endogenous EGF differently in the submandibular glands (SMG) and the kidneys. The aim of the present study was to examine the time-dependent changes in levels of endogenous EGF during 1-4 weeks of EGF treatment. METHODS: Female rats were allocated into five groups receiving EGF subcutaneously (150 microg/kg/day) for 0 (controls), 1, 2, 3 and 4 weeks prior to sacrifice at an age of 12 weeks. At the end of the study period, 24-h urine samples were collected. RESULTS: The weight of the SMG increased during EGF treatment (303+/-33 (controls), 359+/-37 (1 week EGF, P < 0.01), 390+/-30 (4 weeks EGF, P < 0.001) (mg mean+/-S.D.)). The EGF content of the SMG was unchanged after 1 week but threefold decreased after 4 weeks of treatment, respectively. The expression of EGF mRNA was decreased after 1 and 4 weeks as assessed with in situ hybridization. The weight of the kidneys was unchanged after 1 week and increased after 4 weeks of treatment (828+/-105 mg (controls) vs. 935+/-44 mg (4 weeks EGF, P < 0.005)). The renal content and the urinary excretion of EGF were significantly increased by 20-30% only in the group treated for 4 weeks. CONCLUSION: EGF treatment induces a time-dependent decrease in the EGF content in the SMG most likely by reducing the biosynthesis of endogenous EGF. In contrast, the EGF content in kidneys and in urine was unchanged after 1 week and increased after prolonged treatment.

Animals↗
PubMed1998

Epidermal growth factor in the rat prostate: production, tissue content and molecular forms in the different prostatic lobes.

BACKGROUND: Epidermal growth factor (EGF) induces proliferation in prostate epithelial and stromal cells in primary culture. This investigation was set up to characterize the time and spatial expression of EGF in the rat prostate. METHODS: The expression of EGF was characterized in the distinct lobes of the rat prostate by means of ELISA, gel filtration, immunohistochemistry, and in situ hybridization. RESULTS: Local synthesis of EGF by the luminal epithelium was demonstrated by in situ hybridization in the dorsal lobe only. This lobe contained the major part of the prostatic EGF with a sixfold higher concentration than measured in the lateral lobe, and 300-fold higher than in the ventral lobe. Rat prostatic EGF was found to consist of at least two high-molecular-weight forms, as well as a 6-kDa form. The high-molecular-weight forms made up approximately 40% of the EGF measured in the dorsal rat prostate. At 8-12 weeks of age, the concentration of EGF in the dorsal lobe was doubled, with no further increase up to 16 weeks. CONCLUSIONS: We report a 300-fold difference in the lobar content of EGF in the rat prostate, and a doubling of the concentration at 8-12 weeks of age.

Aging↗
PubMed1998

C-reactive protein and bacterial meningitis: a meta-analysis.

The aim of the study was to review published articles on the diagnostic accuracy of C-reactive protein (CRP) tests with cerebrospinal fluid and serum in diagnosing bacterial meningitis. The literature from 1980 and onwards was searched using the electronic databases of MEDLINE, and we used summary receiver operating characteristic curve analyses (SROCs) to describe central tendencies and examine possible sources of inter-study variability in the results. We included data from 35 studies of both children and adults: 21 in which CRP had been measured in cerebrospinal fluid, 10 in which CRP had been measured in serum, and 4 in which it had been measured in both cerebrospinal fluid and serum. The odds ratio for bacterial meningitis versus aseptic meningitis for a positive CRP test with cerebrospinal fluid was estimated at 241 (95% confidence interval [CI]: 59-980), and the central tendencies for the true-positive fraction (sensitivity) and the false-positive fraction (1-specificity) were estimated at 0.94 and 0.06, respectively. The corresponding figures for a CRP test with serum were 150 (95% CI: 44-509), 0.92 and 0.08, respectively. Regression analyses including variables coding for study design features, inclusion of neonatal patients, geographical region, or use of a quantitative biochemical method did not indicate statistically significant contributions to inter-study variances in the log odds ratios. For values of the true- and the false-positive fractions of 0.92-0.94 and 0.06-0.08, respectively, the post-test probability of not having bacterial meningitis given a negative test is very high (> or = 97%), in the range of a pre-test probability (prevalence of bacterial meningitis) from 10 to 30%, whereas the post-test probability of bacterial meningitis given a positive test is considerably lower. Hence, only a negative test is highly informative in a typical clinical setting. This, as well as the absence of analyses to show if CRP tests contribute independent diagnostic information, relatively to the information held in the traditionally used clinical and biochemical variables, makes it difficult to conclude on the clinical usefulness of CRP tests in the management of patients suspected of having bacterial meningitis.

C-Reactive Protein↗
PubMed1998

Pig epidermal growth factor precursor contains segments that are highly conserved among species.

The 53-aa polypeptide epidermal growth factor (EGF) is synthesized as a 1200-aa precursor. The non-EGF part of the precursor is very long compared with EGF, and can therefore be expected to have a biological role of its own. We have sequenced cDNA of the pig EGF precursor and compared a 668-aa segment with that of the human, the rat and the mouse EGF precursors, in order to identify highly conserved domains. The examined part of the precursor contains EGF itself and six so-called EGF-like modules. The overall amino acid identity among the four species is 64%. However, the amino acid identity differed from around 30% in some segments to around 70% in others. The highest amino acid identity, 71%, was observed for a 345-aa segment that contains three EGF-like modules and which is homologous to a part of the low-density lipoprotein receptor (LDL receptor). The amino acid identities are 64% for EGF itself, and 50-67% for the remaining three EGF-like modules. The segment of the LDL receptor that is homologous to a part of the EGF precursor is important for the function of the LDL receptor, and EGF-like modules seem to be involved in protein-protein interactions in a number of proteins. In conclusion, some segments of the EGF precursor are remarkably well conserved among species and it is tempting to speculate that they have a biological function.

Amino Acid Sequence↗
PubMed1998

Urinary excretion of Tamm-Horsfall protein and epidermal growth factor in chronic nephropathy.

Tamm-Horsfall protein (THP) and epidermal growth factor (EGF) are both synthesized by tubular cells in the distal part of the nephron and excreted with the urine. The present study examines the urinary excretion rates of the two peptides in relation to functional tubular markers in patients with chronic nephropathy. Four groups of patients with moderate to severely reduced renal function were studied: glomerulonephritis (n = 10), diabetic nephropathy (n = 11), tubulointerstitial nephropathy (n = 13), and polycystic kidney disease (n = 8). The renal function was evaluated by glomerular filtration rate (GFR) as an indicator for the general renal function, lithium clearance (C(Li)) as an indicator for proximal tubular function, and absolute distal reabsorption of sodium (ADR(Na)) as an indicator for distal tubular function. The excretion rate of EGF was rather closely correlated with GFR, C(Li) and ADR(Na) (Spearman coefficients of variation 0.88, 0.69, and 0.74, respectively). The correlations between the excretion rate of THP and GFR, C(Li) and ADR(Na) were weaker (Spearman coefficients of variation 0.68, 0.42, and 0.44). When the effect of GFR had been accounted for by multiple variance analyses, the excretion rates of the two peptides were still associated with ADR(Na) but not with C(Li). In conclusion, the urinary excretion rates of especially EGF but also those of THP were correlated with renal function and distal tubular reabsorption of sodium in patients with chronic nephropathy.

Adjuvants, Immunologic↗
PubMed1997

Urinary excretion of epidermal growth factor and Tamm-Horsfall protein in three rat models with increased renal excretion of urine.

Epidermal growth factor (EGF) and Tamm-Horsfall protein (THP) are synthesized in the kidneys by the distal tubular cells and excreted into urine. The urinary excretion of these peptides has been suggested as a potential index for distal tubular function. The urinary excretion rates of EGF and THP were examined in three groups of rats with increased renal excretion of urine: uninephrectomy, non-osmotic polyuria and diabetic osmotic polyuria. Twenty-four hour urine samples were obtained after 7, 14 and 21 days. The urinary volume per kidney was doubled in uninephrectomy when compared to controls. There was a seven-fold increase in urinary volume in rats with non-osmotic polyuria and diabetic osmotic polyuria, as compared to controls. Uninephrectomy, non-osmotic polyuria and diabetes all affected the urinary excretion of EGF and THP differently. The EGF excretion in uninephrectomized rats was 60-80% of that of the controls, whereas THP excretion was unchanged, indicating that EGF excretion varied with renal tissue mass. Non-osmotic polyuria caused a five-fold increase in THP excretion but no change in EGF excretion. THP excretion in the diabetic rats was increased three-fold after 21 days when compared to controls, whereas EGF excretion was decreased when expressed per kidney weight. Immunohistochemistry demonstrated that EGF and THP were colocalized in the thick ascending limbs of Henle's loops and distal tubules in all five groups of rats. In conclusion, the EGF excretion appears to follow renal tissue mass and seems independent of urinary volume, whereas THP excretion is dependent mainly on urinary volume. This has implications for the use of EGF and/or THP excretion rates as an indicator for distal tubular function.

Adjuvants, Immunologic↗