PubMed HealthSearch

Biomedical subjects

S Mikkelsen

Publications and source records attributed to S Mikkelsen.

At least 19 recordsLinked to original sources

[PermCath as intravenous access in chronic hemodialysis].

PermCath is a dual-lumen silicone catheter for permanent venous access for hemodialysis. During an observation period from 1 July 1988 to 30 June 1991, 49 PermCath were inserted in 32 patients. In 24 patients (75%), the PermCath was used as sole method of access for hemodialysis through the observation period. Six of the 24 patients required changing of the catheter once, and in three patients the PermCath functioned properly only after the third insertion of a PermCath. In eight patients, vascular access could not be accomplished using the PermCath and these patients were all hemodialyzed through another vascular access. Four patients developed bacteraemia and one patient developed thrombosis of the subclavian vein during the observation period. Insertion of the PermCath is easy and, in case of malfunction, changing or removal of the catheter is easily accomplished. The PermCath is recommended as an alternative to existing techniques for intravenous access for hemodialysis.

Adolescent

Recovery following thiopentone or propofol anaesthesia assessed by computerized coordination measurements.

Quantitative measurements of coordination ability and performance speed were carried out on 76 female day-case patients undergoing minor gynaecological operations. The women were assigned at random to the anaesthetic agent used, propofol 2.5 mg/kg or thiopentone 4 mg/kg. Spacing control, timing control and performance speed were recorded using a newly developed computerized coordination ability test system. The patients were tested once before the operation and 0.5, 1 and 2 h after awakening. Postoperatively the initial impairment and the subsequent regression towards preoperative test results were very similar whether the anaesthetic agent was propofol or thiopentone. Although the test apparatus was able to detect even minor differences, no postoperative test showed statistically significant differences between the two groups. We find it reasonable to conclude that there is no difference in recovery of coordination ability following propofol- or thiopentone-induced anaesthesia.

Adolescent

[Settling times for occupational diseases reported to the National Board of Industrial Injuries].

A representative sample of 151 cases notified to the National Board of Industrial Injuries on a suspicion of an occupational disease were studied with respect to time from notification to final settlement of the case. 50% were settled within 5.5 months, and 75% within 10 months. Settling times were longer for cases accepted for compensation than for dismissed cases. The time used to investigate a case constituted an increasing proportion of the total settling time with increasing settling times. For cases with a settling time of more than nine months, approximately half of the time consisted of waiting time to obtain required information from external sources. It is concluded that a substantial reduction of cases with long settling times depends on a reduction of external expedition times for obtaining required information. The medical profession can contribute to the reduction of settling times by elucidating the case meticulously at the time of notification and by reducing expedition times for requisitions for information.

Denmark

Computerized coordination ability testing.

Quantitative measurements of coordination ability were carried out on 76 women with a median age of 37, range 15 to 60. Spacing control, timing control and performance speed were recorded using newly developed computerized equipment, Catsys, presented in this paper. Twenty-three subjects were re-examined 2-3 months after the first measurements. A fair or even high degree of reproducibility of tests was found. Normal values for the entire group and correlation values for the re-examined group are presented. The results from this small study implies that the Catsys may be useful, e.g., in future clinical neurological practice of diagnostics and follow up on patients, in occupational medicine for detection of neurotoxic effects of various neurotoxic substances, in evaluation of drug effects and side effects and for testing people in occupations where normal coordination skills are absolutely necessary.

Adult

Reporting of occupational cancer in Denmark.

Many patients with occupational diseases fail to obtain compensation because their disease is not recognized as occupational and reported to the authorities. The present study examined the reporting of pleural mesotheliomas and sinonasal adenocarcinomas--cancers with well-known associations with occupational exposures to asbestos and wood dust--in Denmark in 1983-1987. The estimated underreporting was around 50%. Examination of the medical records of patients who had not been reported in 1986-1987 revealed that in most cases the medical records did not contain sufficiently detailed information about occupational exposures. It was recommended that a formal screening interview be carried out whenever a diagnosis is made of a potential occupational cancer. Medical associations may play a major role by issuing guidelines addressing occupational diseases within the fields of their expertise.

Adenocarcinoma

[Plasmapheresis in the treatment of peripheral HIV neuropathy].

Peripheral neuropathy following HIV infection is frequently seen among HIV-positive-, ARC- and AIDS patients who often complain of debilitating paresthesias. Indirect immunofluorescence technique showed antibodies directed either to myelin and/or axons and to endothelial cells of the blood vessels within the nerve tissue. Sural nerve biopsies from five patients showed demyelination, axonal degeneration and perivascular cellular infiltration. Two of the patients had nuclear inclusions and high anti-CMV titer. Plasma exchange was undertaken on five HIV infected patients which resulted in complete disappearance of symptoms in three, incomplete remission in one and no effect in one patient. The finding of autoantibodies against different nerve tissue components, cellular infiltration, positive effect of the plasma exchange and relapse suggests that autoimmunity may play a pathogenetic role in some of the HIV infected patients with peripheral neuropathy.

AIDS-Related Complex

[Abdominal pain precipitated by thoracic segment syndrome].

Referred pain originating from a dysfunctioning thoracic facet joint may simulate abdominal pain. This pain syndrome, the facet syndrome, is probably quite common and perhaps accounts for about 10% of the cases of abdominal pain of unknown origin. Current concepts of the facet syndrome are reviewed and a clinically diagnostic evaluation programme is presented. A case report illustrates the diagnostic problems in daily practice and the need for the clinician to recognize and to look for the facet syndrome.

Abdomen

Decreased retinyl ester concentrations in UV-induced murine squamous cell carcinomas.

Squamous cell carcinomas were induced in hairless mice by repeated irradiations with UVB (280-320 nm, total dose 30 J/cm2) plus UVA (320-400 nm, total dose 168 J/cm2). The irradiated animals and non-irradiated controls were fed on diets with or without vitamin A supplementation (20,000 IU/kg). At the appearance of tumours, 30 to 43 weeks after the last irradiation, the vitamin A (retinol plus retinyl ester) concentrations in the serum, liver, epidermis and tumours and the retinol esterifying activities in microsomes from epidermis and tumours were measured. The liver and epidermal vitamin A concentrations were 2-3 times higher in vitamin A supplemented than in unsupplemented animals, but did not differ between tumour-bearing animals and non-irradiated controls receiving identical diets. The vitamin A concentration in the tumours was significantly lower than in perilesional epidermis. The largest difference (p less than 0.001) between the tumour and epidermal values was observed in the vitamin A supplemented group. The low vitamin A content of the tumours was entirely due to a marked (2 to 6-fold) reduction in the retinyl ester fraction. In contrast, the retinol content of the tumours was increased to twice that of normal epidermis. The activity of the esterifying enzyme, acyl-CoA:retinol acyltransferase (EC 2.3.1.76), was unchanged. The reason for the reduced retinyl ester concentration thus remains unclear. Still, it is possible that a disturbed interconversion of retinol to retinyl esters plays a role in murine photo-carcinogenesis.

Acyltransferases

Health effects due to occupational exposure to cobalt blue dye among plate painters in a porcelain factory in Denmark.

Forty-six plate painters, heavily exposed to cobalt blue dye, took part in this cross-sectional study, and 51 top-glaze painters served as the referents. The study comprised a questionnaire, a health examination, a lung function test, and the determination of the blood and urinary cobalt levels. The plate painters were examined twice, at the end of a workfree period and after resuming work. More plate painters complained of irritation from the mucous membranes in the mouth and throat, cough, and expectoration than the referents. The symptoms increased after the plate painters resumed work. The cobalt level of the plate-painting group after six weeks off work was twice as high in the blood and five times higher in the urine than the corresponding values of the reference group. After the plate painters resumed work, the blood and urinary levels increased approximately 4 and 15 times, respectively. Increased airflow resistance was found in the plate group when compared with the referents, and signs of small airway obstruction increased after the plate painters resumed work. The pulse rate was higher among the plate painters, and minor changes in the red blood cell picture were observed. None of these adverse health effects were associated with the cobalt levels in the blood or urine.

Air Pollutants, Occupational

Mixed solvent exposure and organic brain damage. A study of painters.

In recent years, the possible role of occupational solvent exposure as a cause of chronic effects on the brain has been a matter of increasing concern. The present study was undertaken with the purpose of further investigating this problem, trying to minimize confounding owing to effects of recent solvent exposure and a 'healthy worker' effect. This was accomplished by studying a historical cohort of painters. The material consists of a random sample of 85 painters, and as a non-exposed control group of 85 bricklayers, selected in the same way. Parts of the study are based on this sample supplemented by a sample of 9 painters and 14 bricklayers, selected among subjects with a high degree of complaints on mental impairment. On the basis of a detailed interview on previous solvent exposure, the painters were divided into three groups with low, medium and high solvent exposure, respectively. As signs of organic brain damage we used the degree of dementia and performance in psychometric tests as assessed at a neuropsychological examination; the degree of dyscoordination as assessed from clinical neurological tests; and the degree of cerebral atrophy as assessed from CT-scans of the brain. CT-scans were performed only on a specially selected subsample. The degree of dementia, dyscoordination, and cerebral atrophy increased significantly with the degree of solvent exposure. A similar, but non-significant association was found for the relation between performance in psychometric tests and solvent exposure. The degree of dementia, of dyscoordination, and of cerebral atrophy were positively associated with each other, suggesting that they reflect different aspects of a common underlying factor, an organic brain damage. A review of the literature compared with the results of the present study suggests that a number of studies may have been biased towards negative findings owing to the inclusion in the study material of large proportions of subjects with a solvent exposure that is too little to increase the risk of an organic brain damage. Conflicting results between different studies on performance in psychometric tests may also arise from insufficient adjustment for primary intellectual level.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult

Fibrolipomatous hamartoma of the median nerve.

A case of fibrolipomatous hamartoma of the median nerve is presented. The operative findings were characteristic. The diagnosis should be confirmed by histological examination of a biopsy from an involved palmar cutaneous branch, and treatment should be limited to decompression of the ligament or fascia over the involved area.

Child, Preschool

Refraining from cigarette smoking before premedication does not decrease the risk of acid pulmonary aspiration during anaesthesia.

Seventy-four habitual smokers who had refrained overnight from cigarette smoking and were undergoing elective orthopedic surgery were allocated randomly to two groups in order to investigate the effect of smoking two cigarettes before premedication on volume and pH of gastric contents. The smoking group was allowed to smoke two cigarettes while the non-smoking group was not allowed to smoke. There was no significant difference in volume or pH between the groups, either just after intubation or prior to extubation, thus indicating no decreased risk of acid pulmonary aspiration because of refraining acutely from cigarette smoking.

Adolescent