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S Sørensen

Publications and source records attributed to S Sørensen.

At least 19 recordsLinked to original sources
PubMed2003

Accuracy of telemedical home blood pressure measurement in the diagnosis of hypertension.

This study was conducted to compare the accuracy of clinic blood pressure (CBP) and telemedical home blood pressure (HBP) measurement in the diagnosis of hypertension in primary care. The study subjects were 411 patients with average CBP > or =140 mmHg systolic or > or =90 mmHg diastolic, who performed telemedical HBP measurement (5 days, four times daily) and ambulatory blood pressure (ABP) monitoring in random order. Main outcome measure was the agreement of CBP and HBP with daytime ABP. CBP was much higher than daytime ABP and average HBP (P<0.001) with no difference between the latter two. The correlation between CBP and ABP was weak (systolic: r=0.499, diastolic: r=0.543), whereas strong correlations existed between HBP and ABP (systolic: r=0.847, diastolic: r=0.812). A progressive improvement in the strength of the linear regression between average HBP of single days and ABP was obtained from day 1 to day 4, with no further benefit obtained on the fifth day. The HBP readings taken at noon and in the afternoon showed significantly stronger correlations with ABP than the blood pressures measured in the morning and in the evening. In conclusion, the accuracy of telemedical HBP measurement was substantially better than that of CBP in the diagnosis of hypertension in primary care. HBP most accurately reflected ABP on the fourth day of monitoring, and the readings at noon and in the afternoon seemed to be most accurate.

Adult↗
PubMed2003

Preanalytical handling of samples for measurement of plasma lactate in HIV patients.

Lactic acidosis is a feared side effect of nucleoside analog treatment, one of the cornerstones in the management of HIV infection. Precise and reliable lactate measurements are prerequisites for the diagnosis of hyperlactatemia. The effects of venous stasis, time to measurement and storage temperature on p-lactate levels, p-glucose levels, anion gap and pH were investigated. Ten HIV patients (n=8 on highly active antiretroviral therapy) and 4 healthy control subjects were studied. Blood was drawn without stasis at time 0 and with stasis for 2 and 8 min into heparin-preserved test tubes. The tubes were placed at a room temperature (25 degrees C) and on crushed ice and consecutively monitored for up to 360 min. The mean increases in p-lactate in blood kept in test tubes at 25 degrees C, measured from 0 to 60 min and from 240 to 360 min, were increased in HIV patients compared with controls (0.78 mmol/Lh +/- 0.02 vs. 0.63 mmol/Lh +/- 0.05, (p=0.009) and 0.65 mmol/Lh +/- 0.03 vs. 0.53 mmol/Lh +/- 0.05, (p=0.042)). It was found that placing the tubes on crushed ice rather than keeping them at 25 degrees C controlled glycolysis and lactate production measured over a 6-h period (0.033 mmol/Lh +/- 0.006 vs. 0.32 mmol/Lh +/- 0.01, (p<0.0001) and 0.064 mmol/Lh +/- 0.008 vs. 0.64 mmol/Lh +/- 0.02, (p<0.0001)). The total increases in lactate levels in the test tubes placed on crushed ice for 4 h and in those kept at 25 degrees C for 15 min were comparable (0.28 +/- 0.03 mmol/L vs. 0.20 +/- 0.03). Compared with storage at 25 degrees C, keeping the test tubes on crushed ice also preserved pH and anion gap over a 6-h measurement period (pH: 0.026 +/- 0.004 vs. 0.12 +/- 0.01 and anion gap: -0.8 +/- 0.4 mmol/L vs. 4.1 +/- 0.4). Two minutes of venous stasis had no influence on p-lactate levels (0.02 +/- 0.04 mmol/L, p=0.70), whereas 8 min of stasis increased p-lactate levels by 0.11 +/- 0.04 mmol/L, p=0.009. It is concluded that major errors in measurements of p-lactate, anion gap and pH can be prevented by placing test tubes on crushed ice for up to 4 h until measurement.

Acidosis, Lactic↗
PubMed2001

Increased levels of specific leukocyte- and platelet-derived substances during normal anti-tetanus antibody synthesis in patients with inactive Crohn disease.

BACKGROUND: Crohn disease is considered a consequence of inappropriate upregulation of immune reactions evoked by the intestinal microflora or luminal antigens. Since the intestinal mucosa is continuously exposed to tetanus toxoid we studied the antibody response to tetanus toxoid booster immunization in patients with Crohn disease and the subsequent release of various inflammatory mediators and growth factors in blood. METHODS: Ten patients with inactive disease and no concurrent medication and 12 age-and gender-matched healthy volunteers with anti-tetanus antibody levels less than 0.1 IU/ml were inoculated with 1 ml (6 Lf units) of tetanus toxoid vaccine. The anti-tetanus antibody levels were determined in serum obtained before inoculation and after 7, 14 and 28 days, respectively. C-reactive protein (CRP), interleukin-6 (IL-6), tumour necrosis factor-alpha (TNF-alpha), histamine, vascular endothelial growth factor (VEGF), tissue inhibitor of metalloproteinases-1 (TIMP-1), plasminogen activator inhibitor type-1 (PAI-1) and myeloperoxidase (MPO) were determined in serum or plasma obtained on the same days. RESULTS: After inoculation anti-tetanus antibody levels were equally raised in patients and healthy volunteers. Pre-inoculation CRP levels were below the upper level of the normal range (<10 mg/l) in all inoculated patients/volunteers. No differences in IL-6, TNF-alpha, MPO or histamine levels between patients and healthy volunteers were observed. CRP levels were within the normal range and IL-6, TNF-alpha, MPO and histamine levels were unchanged in patients and volunteers during the study period. The levels of VEGF, TIMP-1 and PAI-1 were unchanged in the healthy volunteers during the study period, but were significantly (P < 0.05) increased at day 14 in patients with Crohn disease. At day 28 the levels had fallen to pre-inoculation levels, apart from PAI-1, which was still significantly (P<0.05) increased. CONCLUSIONS: In patients with inactive Crohn disease, booster immunization against tetanus toxoid seems to result in normal anti-tetanus antibody synthesis, but it may cause inappropriate release of certain bioactive substances, which are known to play a major role in modulation of the inflammatory response.

Adult↗
PubMed2001

Expression of nitric oxide synthases and effects of L-arginine and L-NMMA on nitric oxide production and fluid transport in collagenous colitis.

BACKGROUND AND AIMS: Luminal nitric oxide (NO) is greatly increased in the colon of patients with collagenous and ulcerative colitis. To define the source and consequence of enhanced NO production we have studied expression of NO synthase (NOS) isoforms and nitrotyrosine in mucosal biopsies from these patients. In addition, effects on colonic fluid transfer caused by manipulating the substrate of NOS were studied in patients with collagenous colitis. PATIENTS: Eight patients with collagenous colitis, nine with active ulcerative colitis, and 10 with uninflamed bowel were included. METHODS: Expression of NOS isoforms was quantified by western blotting. Inducible NOS (iNOS) and nitrotyrosine were localised by immunohistochemistry. Modulation of NOS activity by topical N(G)-monomethyl-L-arginine (L-NMMA) or L-arginine was assessed during perfusion of whole colon. Plasma and perfusate nitrite/nitrate (NOx) was measured by Griess' reaction. RESULTS: Both in collagenous and ulcerative colitis, expression of iNOS was 10(2)-10(3) higher (p<0.001) than in uninflamed bowel and localised primarily to the epithelium. Endothelial NOS was evenly expressed in all groups while neuronal NOS was undetectable. Nitrotyrosine was markedly expressed in active ulcerative colitis but rarely detected in collagenous colitis and never in uninflamed bowel. In collagenous colitis, the output of NOx was markedly increased compared with uninflamed bowel (283 (58) v <37 nmol/min; p<0.01) and fluid was net secreted. L-NMMA reduced the output of NOx by 13-66% (95% confidence intervals) and secretion of fluid by 25-109% whereas L-arginine increased the output of NOx by 3-39% and secretion of fluid by 15-93%. CONCLUSIONS: In collagenous colitis, as opposed to ulcerative colitis, upregulation of iNOS occurs in the absence of nitrotyrosine formation and mucosal damage. Excess generation of NO may be the primary cause of diarrhoea in this condition.

Adult↗
PubMed2001

zeta-, epsilon-, and gamma-Globin mRNA in blood samples and CD71(+) cell fractions from fetuses and from pregnant and nonpregnant women, with special attention to identification of fetal erythroblasts.

BACKGROUND: Information about the appearance of gamma-, epsilon-, and zeta-globin mRNAs in fetal erythroblasts during gestation and about the presence and amounts of these mRNAs in pregnant and nonpregnant women is important from the perspective of using these molecules as a marker of fetal erythroblasts. A specific marker is necessary for isolation and identification of fetal nucleated red blood cells from maternal blood samples for use in antenatal diagnosis of fetal genetic or chromosomal abnormalities. METHODS: We used a very sensitive reverse transcription-PCR (RT-PCR) method, coamplification analysis of gamma- and epsilon-globin cDNA, and quantitative analysis of gamma-globin mRNA based on competitive RT-PCR to investigate these aspects. RESULTS: All adult whole-blood samples were negative for epsilon- and zeta-globin mRNA. Analyses of CD71(+) cell fractions showed that specimens from 19 of 20 nonpregnant and 10 of 14 pregnant women (at 9-13 weeks of gestation) were positive for gamma-globin mRNA (Fisher's exact test, P = 0.13), and those from 3 of 20 nonpregnant and 5 of 14 pregnant women were positive for zeta-globin mRNA (Fisher's exact test, P = 0.23). No epsilon-globin mRNA was detected in CD71(+) cell fractions from 1-mL blood samples from adults. CD71(+) cell fractions from eight fetal blood samples (at 17-20 weeks of gestation) were positive for all three globin mRNAs. We found no statistically significant difference between the amounts of gamma-globin mRNA in pregnant and nonpregnant women. CONCLUSIONS: This study indicates that epsilon-globin mRNA might function as a marker for fetal CD71(+) cells early in pregnancy. Although gamma-globin mRNA can be detected in CD71(+) cell fractions from most adults, these transcripts also may be of use because of a marked difference between adult and fetal values.

Adult↗
PubMed2000

Supercritical fluid chromatography as a method of analysis for the determination of 4-hydroxybenzylglucosinolate degradation products.

In the present study analytical and preparative supercritical fluid chromatography (SFC) were used for investigation of myrosinase catalysed degradation of 4-hydroxybenzylglucosinolate (sinalbin). Sinalbin occurs as a major glucosinolate in seeds of Sinapis alba L., in various mustards and other food products. The degradation products were identified and quantified by analysis based on a developed SFC method using a bare silica column. Determinations comprised transformation products of sinalbin, produced both during degradation of isolated sinalbin, and during autolysis of meal from S. alba seeds. The conditions in the developed SFC method were used as basis for the preparative SFC procedure applied for isolation of the components prior to their identification by nuclear magnetic resonance (NMR) spectroscopy. Myrosinase catalysed sinalbin hydrolysis resulted in the reactive 4-hydroxybenzyl isothiocyanate as an initial product at pH values from 3.5 to 7.5 whereas 4-hydroxybenzyl cyanide was one of the major products at low pH values. 4-Hydroxybenzyl isothiocyanate was found to disappear from the aqueous reaction mixtures in a few hours, as it reacted easily with available nucleophilic reagents. 4-Hydroxybenzyl alcohol was found as the product from reaction with water, and with ascorbic acid, 4-hydroxybenzylascorbigen was produced.

Acetonitriles↗
PubMed2000

Supercritical fluid chromatography as basis for identification and quantitative determination of indol-3-ylmethyl oligomers and ascorbigens.

Indol-3-ylmethylglucosinolate (glucobrassicin) occurs in most plants of the Brassicaceae family together with hydroxy and methoxy derivatives of glucobrassicin. These compounds and products produced therefrom have been the subject of considerable research interest due to their potential anticarcinogenic effects, and thereby a need for techniques to work with the individual compounds. A method using normal-phase supercritical fluid chromatography (SFC) with methanol as modifier has been developed for determination and quantification of the various indol-3-ylmethyl derivatives including ascorbigens formed from the glucobrassicin degradation product, indol-3-ylmethanol, under acidic conditions (pH 2-6) with and without the presence of ascorbic acid. The SFC method had detection limits in the 10-100-pmol range. In the absence of ascorbic acid a range of oligomers were formed, whereas the presence of ascorbic acid favoured the formation of ascorbigen and products thereof. Quantitatively important indol-3-ylmethyl oligomers consisting of up to five indol rings have been purified with preparative SFC and identified from MS and 1D and 2D NMR experiments with complete assignment of chemical shifts to all of the atoms. Investigation of the autolysis products of white cabbage showed that ascorbigens were the quantitatively dominating degradation products of indol-3-ylmethylglucosinolates.

Ascorbic Acid↗
PubMed2000

Preoperative plasma plasminogen activator inhibitor type-1 and serum C-reactive protein levels in patients with colorectal cancer. The RANX05 Colorectal Cancer Study Group.

BACKGROUND: Preoperative plasma plasminogen activator inhibitor-1 (PAI-1) is a prognostic variable in patients with colorectal cancer. It has been suggested, however, that plasma PAI-1 is a nonspecific prognostic parameter similar to the acute-phase reactant C-reactive protein (CRP). In the present study we analyzed the association between plasma PAI-1 and serum CRP in patients scheduled for elective resection of colorectal cancer. In addition, the prognostic value of PAI-1 and CRP was studied in this patient cohort. METHODS: PAI-1 and CRP were analyzed in citrated plasma and serum, respectively, obtained preoperatively from 594 patients. Patients who required preoperative blood transfusion received SAGM blood, in which soluble PAI-1 is not present. None of the patients received pre- or postoperative adjuvant chemotherapy, and all were followed in the outpatient clinic for at least 5 years or until death. The association of PAI-1 and CRP, respectively, with survival was tested using the median value of PAI-1 and the upper normal limit for CRP. Analyses were performed by inclusion of all patients, and in the subgroup of patients, who underwent curative resection. RESULTS: The median follow-up period was 6.8 (5.4-7.9) years. The median value of plasma PAI-1 was 35.8 ng/ml, and values greater than 94 nmol/L identified patients with increased CRP levels. Comparison of the molecules showed that PAI-1 was weakly correlated with CRP (r = .26; P <.0001). Both molecules showed a Dukes independent distribution. In univariate survival analyses high levels of PAI-1 were found associated with poor prognosis and low levels with good prognosis (P = .02, HR: 1.3). Similarly, high levels of CRP were found associated with poor prognosis and low levels with good prognosis (P <.0001, HR: 1.9). In a multivariate statistical analysis including Dukes classification, gender, age, tumor location, perioperative blood transfusion, PAI-1 and CRP, plasma PAI-1 was a dependent prognostic variable, while serum CRP (P <.0001; HR: 1.4; 95% CI: 1.3-1.5) was found to be a Dukes independent prognostic variable. Similar analyses, excluding patients with Dukes' D disease showed serum CRP to be an independent prognostic variable (P <.0001; HR: 1.3: 95% CI: 1.2-1.5). CONCLUSIONS: This study did not show a strong correlation between plasma PAI-1 and serum CRP in patients with colorectal cancer. Serum CRP was found to be a Dukes independent prognostic variable in this patient cohort, and was found to identify a subgroup of curatively resected patients at risk for short survival.

Adult↗
PubMed2000

Serial measurements of serum human placental lactogen (hPL) and serial ultrasound examinations in the evaluation of fetal growth.

Serial serum hPL measurements and serial ultrasound fetometry were compared in the evaluation of fetal growth by relating these two parameters to size at birth and to clinical factors known to influence size at birth. The data were from a prospective study of 1000 consecutive pregnant women considered to be at risk for fetal growth retardation with retrospective analysis. Serum hPL was measured by radioimmunoassay and fetal weight estimated by ultrasound every 3 weeks during the last trimester. hPL values were expressed as multiples of the median (MoM) and linear regression analysis of the hPL MoM values was carried out for each pregnancy to find the slope of the line (hPL-slope); at least 3 serum hPL values were required. The estimated fetal weight and weight-for-age at birth was expressed in Z-scores. The individual intrauterine growth velocity was calculated by regression analysis and expressed as change in Z-score for 12 weeks. At least two ultrasound measurements over an interval of at least 42 days were used to estimate the fetal growth velocity. In 588 women the file was complete. The main outcome measures were the individual mean hPL, hPL-slope, fetal growth velocity, birth weight deviation, smoking in pregnancy and diagnosis of preeclampsia. A significant correlation was found between the hPL-slope and the intrauterine fetal growth velocity (r=0.34), and between hPL-slope and birth weight deviation (r=0.32). Mean hPL was correlated to birth weight deviation (r=0.27), but only very weakly to intrauterine growth velocity (r=0.08). hPL-slope and intrauterine growth velocity independently predicted birth weight deviation. Heavy smoking which was stopped before the third trimester was not associated with low intrauterine growth velocity, but with a low hPL-slope. Preeclampsia was associated with a trend towards low and decreasing hPL and with an increasing intrauterine growth velocity and birth weight deviation. In conclusion the rate of change of serial hPL measurements correlated well to intrauterine fetal growth velocity in the third trimester as estimated by ultrasound and to the deviation in birth weight, but hPL seems to have a separate physiological significance, since it did not pick up when smoking was stopped and growth velocity was normalised and it did not at all detect the increased growth associated with preeclampsia.

Birth Weight↗
PubMed2000

Determination of ascorbigens in autolysates of various Brassica species using supercritical fluid chromatography.

A new method of analysis based on normal phase supercritical fluid chromatography (SFC) has been developed for investigation of ascorbigens [2-C-(indol-3-ylmethyl)-beta-L-xylo-3-hexulofuranosonic acid gamma-lactone derivatives]. This method has been adapted to preparative isolation and quantitative determinations of individual ascorbigens comprising ascorbigen, neoascorbigen, and 4-methoxyascorbigen. The structures of these compounds have been revealed from 1D ((1)H, (13)C) and 2D (COSY, HMQC, HMBC) NMR experiments. The developed SFC method had an acceptable linearity for the ascorbigens with correlation coefficients (R(2)) > 0.9995 (n = 10) in the range of 0.13-4.9 nmol injected, detection limits were below 13 pmol, retention time stabilities were excellent, and relative response factors have been determined. The SFC method has been used for determination of ascorbigens produced during autolysis of indol-3-ylmethylglucosinolates in various Brassica vegetables and rapeseed seedlings. Generally, 30-60% of the indol-3-ylmethylglucosinolates in the plants were transformed into ascorbigens, with the concentration in autolysates varying from 0.51 +/- 0.002 to 3.72 +/- 0.21 micromol/g of dry weight (DW) for ascorbigen, from 0.05 +/- 0.01 to 2.42 +/- 0.23 micromol/g of DW for neoascorbigen, and from 0.03 +/- 0.002 to 0.84 +/- 0.07 micromol/g of DW for 4-methoxyascorbigen.

Ascorbic Acid↗
PubMed1999

Plasma urokinase receptor levels in patients with colorectal cancer: relationship to prognosis.

BACKGROUND: The proteolytic enzyme plasmin, which is generated from the precursor plasminogen by the action of urokinase plasminogen activator, is thought to play a role in tumor cell invasion and metastasis. Urokinase plasminogen activator receptor (uPAR) is functionally involved in the cell surface activation (i.e., cleavage) of plasminogen. Increased tumor tissue levels of uPAR are associated with poor prognosis in several types of cancer. This retrospective study was undertaken to test the relationship between preoperative plasma levels of soluble uPAR (suPAR) and survival in patients with colorectal cancer. METHODS: suPAR levels in preoperative plasma from 591 patients with colorectal cancer were determined by use of a kinetic enzyme-linked immunosorbent assay and analyzed with respect to associations with postoperative survival, Dukes' stage, age, and serum carcinoembryonic antigen level. Plasma suPAR measurements were log transformed for survival analysis, which employed the Kaplan-Meier method and the Cox proportional hazards model. All P values reported are two-sided. RESULTS: Univariate analysis, using the log-transformed suPAR concentrations, demonstrated that there was an increasing risk of mortality with increasing plasma suPAR level (P<.0001). An arbitrary cut point, the median for all patients (1.37 ng/mL), divided patients with Dukes' stage B, C, or D disease into statistically different prognostic groups. In multivariate Cox analysis including Dukes' stage, age, and carcinoembryonic antigen level, the suPAR concentration independently predicted survival (P<.0001). CONCLUSIONS: The preoperative plasma suPAR level independently predicted survival of patients with colorectal cancer. Further studies of plasma suPAR in patients with cancer are needed to evaluate the utility of plasma suPAR measurements and cut points in identifying high-risk patients among those with early stage disease.

Adult↗
PubMed1999

Detection of fetal-specific DNA after enrichment for trophoblasts using the monoclonal antibody LK26 in model systems but failure to demonstrate fetal DNA in maternal peripheral blood.

Trophoblast cells can be detected in maternal blood during normal human pregnancy and DNA from these cells may be used for non-invasive prenatal diagnosis of inherited diseases. The possibility of enriching trophoblast cells from maternal blood samples using a monoclonal antibody (LK26) against a folate-binding protein, which recognizes trophoblast in normal tissues, in conjunction with immunomagnetic cell sorting was investigated. Verification of the presence of fetal DNA in the sorted samples was done by detection of fetal/paternal-specific short tandem repeat (STR) alleles using polymerase chain reaction (PCR) and automated fluorescence-based genotyping. After successful initial experiments using retroplacental blood samples with a high number of trophoblast cells or an artificial mixture of trophoblast cells and blood, several versions of the enrichment method were attempted on peripheral maternal blood samples. However, it was not possible to detect fetal DNA sequences in these samples, most probably due to the extremely low number of trophoblast cells. Positive identification and retrieval of trophoblast cells in suspension or trophoblast nuclear material prepared on microscope slides after cell sorting procedures can be a solution to this problem.

Antibodies, Monoclonal↗
PubMed1999

Polymorphism in the regulatory region located more than 1.1 kilobases 5' to the start site of transcription, the promoter region, and exon 1 of the HLA-G gene.

The non-classic Human Leucocyte Antigen class Ib molecule, HLA-G, is expressed on the invasive, extra-villous cytotrophoblast in human placenta. HLA-G protects against natural killer (NK)-cell-mediated lysis and may modulate the secretion of cytokines. Aberrant expression of HLA-G has been reported in certain disorders of pregnancy. We have studied the DNA sequences of the putative regulatory region located more than 1.1 kilobases 5' from the start site of transcription (a 244 bp HindIII/EcoRI fragment) of the HLA-G gene and of the promoter region to detect any possible polymorphism. We detected one nucleotide substitution in the HindIII/ EcoRI region and one in the promoter region in the alleles G*01012, G*01013, G*0104, and G*0105N compared to G*01011. Several nucleotide substitutions were detected in the region between the 1.1 kb 5' regulatory region and the promoter region. Alleles can be divided into two groups based on the detected polymorphism. The nucleotide substitutions may have implications for the binding of nuclear factors to the regulatory regions. To our knowledge this is the first study of any polymorphism in the 5'-flanking sequences to the HLA-G gene. Further studies are needed to elucidate the exact impact of the detected polymorphism on levels or developmental regulation of HLA-G expression.

Base Sequence↗
PubMed1999

Serum YKL-40 and colorectal cancer.

YKL-40 is a mammalian member of the chitinase protein family. Although the function of YKL-40 is unknown, the pattern of its expression suggests a function in remodelling or degradation of extracellular matrix. High serum YKL-40 has been found in patients with recurrent breast cancer and has been related to short survival. In the present study we analysed YKL-40 in preoperative sera from patients with colorectal cancer and evaluated its relation to survival. Serum YKL-40 was determined by RIA in 603 patients. Survival after operation was registered, and median follow-up time was 61 months. Three hundred and forty patients died. Sixteen per cent of the patients with Dukes' A, 26% with Dukes' B, 19% with Dukes' C and 39% with Dukes' D had high serum YKL-40 levels (adjusted for age). Analysis of serum YKL-40 as a continuous variable showed an association between increased serum YKL-40 and short survival (P < 0.0001). Patients with high preoperative serum YKL-40 concentration had significantly shorter survival than patients with normal YKL-40 (HR = 1.7; 95% CI: 1.3-2.1, P < 0.0001). Multivariate Cox analysis including serum YKL-40, serum CEA, Dukes' stage, age and gender showed that high YKL-40 was an independent prognostic variable for short survival (HR = 1.4; 95% CI: 1.1-1.8, P = 0.007). These results suggest that YKL-40 may play an important role in tumour invasion.

Adipokines↗
PubMed1999

Limb salvage experience in a multidisciplinary diabetic foot unit.

OBJECTIVE: To assess the results of the strategy used in avoiding major amputations in patients admitted to a vascular surgical department with a new multidisciplinary diabetic foot unit. RESEARCH DESIGN AND METHODS: The study was retrospective. A total of 162 patients (172 limbs) were classified into three groups. Group A1 had limb-threatening ischemia and were undergoing revascularization (85 patients, 91 legs). Group A2 had limb-threatening ischemia, but revascularization was not feasible for them (23 patients). Group B had foot ulcers due to peripheral neuropathy and did not require arterial reconstruction (54 patients, 58 legs). RESULTS: In group A1 there were 115 revascularizations; 42 conduits had outflow to crural arteries and 14 to pedal arteries. Resection of gangrene was required in 43% of the limbs. The chances of preserved limb at 1 and at 24 months were 95 and 85%, respectively, and the chances of patient survival were 89 and 64%. In group A2, the chances of preserved limb at 1 and at 24 months were only 35 and 17%, respectively, and the chances of patient survival were only 64 and 16%. In group B, 51 of 58 limbs suffered invasive infection; debridement of the ulcers required resection of toes or part of the foot in 64% of cases. The chances of preserved limb at 1 and at 24 months was 98 and 86%; the chances of patient survival were 98 and 68%. Ankle and toe systolic pressures were less suitable than repeated clinical examinations in deciding the need for revascularization. CONCLUSIONS: Major amputation can be avoided in about 80% of patients with limb-threatening ischemia and in about 95% with foot ulceration complicated with infection. Multifactorial treatment of the complex foot lesions by a multidisciplinary foot care team is considered mandatory to obtain satisfactory limb salvage.

Amputation, Surgical↗
PubMed1998

Characterisation of non-maternal serum proteins in amniotic fluid at weeks 16 to 18 of gestation.

Proteins found in amniotic fluid are mainly serum proteins, probably of maternal origin. About 5% of the total protein concentration has the potential of being fetal or decidual in origin. Only a few of these proteins have been isolated and characterised. In order to describe the foetal and decidual components in amniotic fluid more extensively, a polyspecific antiserum to amniotic fluid at weeks 16-18 of gestation was raised. Specificities in the antiserum to serum proteins were removed by adsorption. Several proteins of non-serum protein origin reacted with the antiserum. Three of these proteins were chosen for isolation and further characterisation. With the use of immunological methods, SDS-PAGE and N-terminal sequencing we identified two of the proteins as C-terminal propeptides of procollagen Type I and Type III, which have not hitherto been described in amniotic fluid. The third protein, called here protein-4, showed up as homologous to fetal antigen-1 (FA-1) and human dlk, containing EGF-like domains and associated with growth in neuroendocrine tissues and tumours.

Amino Acid Sequence↗
PubMed1998

Determination of vitamins in food based on supercritical fluid extraction prior to micellar electrokinetic capillary chromatographic analyses of individual vitamins.

The separation of 14 water-soluble vitamins and vitamin cofactors was investigated by micellar electrokinetic capillary chromatography and diode array detection using sodium cholate as the micellar phase. The method was optimised with respect to the effect of buffer composition, capillary temperature and applied voltage resulting in separation of all compounds in about 25 min. With the current method it is possible to predict the eluting order of the individual compounds from their net charges of each compound because of a low ion pairing between solutes and micelles. The linearities within concentration ranges of up to two-orders of magnitudes were good with correlation coefficients from 0.971 to 0.997. The separation efficiency was satisfactory with a good resolution ranging from 2 to 45 and a theoretical number of plates varying from 200,000 to 480,000. The repeatability of the developed method showed relative standard deviations on migration time in the range from 0.5% to 1.2% (n = 15) and for normalised peak areas, relative standard deviations were approximately 6%.

Beverages↗