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Biomedical subjects

T Dahl

Publications and source records attributed to T Dahl.

At least 19 recordsLinked to original sources

Data quality of surgery for carotid artery stenosis. Are the national vascular registries reliable?

OBJECTIVES: To study completeness of reporting carotid endarterectomies, including peri-operative stroke and mortality rate, in a national vascular registry, NorKar, and a national administrative registry, The Norwegian Patient Register (NPR). DESIGN: Comparative registry-based national study. MATERIALS: Member hospitals of NorKar, including 89% of carotid endarterectomies in Norway, were compared with relevant data in NPR for the years 2000-2002. METHODS: We compared procedure-codes, diagnosis-codes, in-hospital death and the occurrence of peri-operative stroke after treatment for carotid artery stenosis in the two registries to evaluate completeness. RESULTS: Compared with the NPR numbers, 16% of carotid endarterectomies were missing in the reports from member hospitals of NorKar. Further, during this three-year period, there was an under-reporting of seven strokes and two deaths. The discrepancy was most pronounced in 2001. CONCLUSIONS: There is an under-reporting of patients operated on for carotid artery stenosis in NorKar according to NPR numbers as well as an under-reporting of early deaths and strokes. There is a need for better quality data in the NorKar Registry. Registry quality would be likely to improve if patient identifiable data were available in both registries.

Angioplasty, Balloon↗

Carotid endarterectomy: time-trends and results during a 20-year period.

AIM: The aim of this study was to evaluate the results following surgery for carotid artery stenosis in a single institution during a 20-year period. METHODS: In a retrospective study, 556 operations were performed in 496 patients during the period 1983-2002. Comorbidities, mortality, stroke and other surgical and general complications were recorded. Follow-up was performed and data retrieved from medical records, questionnaires, and visits to local hospitals. Data on late mortality were retrieved from the Norwegian Registrar's Office of birth and deaths. RESULTS: The mean age was 66.9 years (range 43-84 years), and 60% were men; 84% had symptomatic carotid artery stenosis. General anesthesia was applied in 95.5%. A shunt was used in 61.3%, and patch angioplasty in 95.1%. Autologous vein patch was used in almost all cases and there were no cases of patch rupture. Postoperative myocardial infarction occurred in 16 (2.9%) of the patients, and 5 were fatal. All types of stroke within 30 days of surgery occurred in 23 (4.1%) including 1 fatal stroke, and 7 patients died of other causes. The total stroke/mortality rate was 5.4%. Patients with previous coronary artery bypass had a favorable outcome regarding long-time survival. In contrast, increasing age, diabetes, renal failure and intermittent claudication predicted reduced long-term survival. No operations were performed for recurrent stenosis. CONCLUSIONS: We have used fairly the same policy regarding operative technique during the 20-year period and the results are in agreement with those presented in large international trials. The long-term results were favorable, and improved over time, probably due to better preoperative evaluation of the patients, better timing of surgery and treatment of comorbidities.

Adult↗

Effect of blood donation on maximal oxygen consumption.

AIM: This study determined the effect of donating one unit of blood on various physiological parameters associated with a VO2(max) test. METHODS: Ten healthy, male subjects (23+/-4 years, 178+/-7.6 cm, 74.4+/-12.3 kg) completed a VO2(max) test 24 h before donating one unit of blood (~500 mL) and 24 h after donating blood. The Bruce protocol was used to determine the subjects' VO2(max). Physiological responses were measured at the end of the VO2(max) test. A repeated measures ANOVA was used to determine if there were significant (P<0.05) differences in the subjects' physiological responses between the VO2(max) before and after blood donation. RESULTS: Significant differences were found in VO2(max) (mean+/-SD, 3.18+/-0.74 vs 2.87+/-0.53 L.min(-1)), cardiac output (Q, 25+/-5 vs 22.5+/-3.3 L.min(-1)), stroke volume (SV, 134+/-37 vs 121+/-22 mL.beat(-1)), delivery of oxygen (DO(2), 5+/-.87 vs 3.97+/-.68 L.min(-1)), and hemoglobin concentration (Hb, 153+/-12 vs 135+/-16 gm.L(-1)). No significant changes were observed for heart rate (HR); arteriovenous oxygen difference (a-vO(2) diff), systolic blood pressure (SBP), and diastolic blood pressure (DBP). CONCLUSIONS: These findings indicate that donating one unit of blood decreased VO2(max) due to the decrease in Q, which resulted from the decrease in SV since HR was unchanged. The lower VO2(max) along with the decrease in DO(2) would be expected to have a negative effect on athletic performance.

Adult↗

Ruptured abdominal aortic aneurysm secondary to tuberculous spondylitis.

A 69-year-old man was admitted with low back pain and signs of nerve root compression. A computed tomography (CT) scan showed abscess formation in the left psoas region, spondylodiscitis L3-L4 and a ruptured abdominal aortic aneurysm. The aortic aneurysm was replaced with a bifurcated vascular graft. One week later, laminectomy at the L4-level was done. In a small abscess, Mycobacterium bovis was found. The condition was considered to be a mycobacterial spondylitis secondary to BCG instillations of the urinary bladder for carcinoma. The patient received antituberculous medication for 9 months. Subsequently bone transplantation and internal fixation of the spine became necessary. Three years after surgery he is in good condition and there are no signs of graft infection on CT. Spondylitis and mycotic aortic aneurysm should be kept in mind in patients who have been treated for carcinoma of the bladder with BCG instillations.

Aged↗

Multiple microscopy modalities applied to a sea urchin tooth fragment.

Two synchrotron X-ray microscopy methods, phase-contrast microradiography (the propagation method) and absorption microCT (high-resolution computed tomography or microtomography), and laser-scanning confocal microscopy (visible wavelength) were used to study a fragment of the keel of a tooth of the sea urchin Lytechinus variegatus. Stripes observed in the phase-contrast images of the fragment were also seen in confocal micrographs. MicroCT showed that the stripes were due to two parallel planar arrays of low-absorption channels within the bulk of the keel. In the phase microradiographs, maximum contrast stripes appear when a channel image from one row coincides with a channel image from the second row; otherwise, contrast is minimal. Long channels do not appear to have been observed previously in keels of sea urchin teeth.

Animals↗

Synchrotron X-ray studies of the keel of the short-spined sea urchin Lytechinus variegatus: absorption microtomography (microCT) and small beam diffraction mapping.

In sea urchin teeth, the keel plays an important structural role, and this paper reports results of microstructural characterization of the keel of Lytechinus variegatus using two noninvasive synchrotron x-ray techniques: x-ray absorption microtomography (microCT) and x-ray diffraction mapping. MicroCT with 14 keV x-rays mapped the spatial distribution of mineral at the 1.3 microm level in a millimeter-sized fragment of a mature portion of the keel. Two rows of low absorption channels (i.e., primary channels) slightly less than 10 microm in diameter were found running linearly from the flange to the base of the keel and parallel to its sides. The primary channels paralleled the oral edge of the keel, and the microCT slices revealed a planar secondary channel leading from each primary channel to the side of the keel. The primary and secondary channels were more or less coplanar and may correspond to the soft tissue between plates of the carinar process. Transmission x-ray diffraction with 80.8 keV x-rays and a 0.1 mm beam mapped the distribution of calcite crystal orientations and the composition Ca(1-x)Mg(x)CO(3) of the calcite. Unlike the variable Mg concentration and highly curved prisms found in the keel of Paracentrotus lividus, a constant Mg content (x = 0.13) and relatively little prism curvature was found in the keel of Lytechinus variegatus.

Animals↗

Three-dimensional microarchitecture of the plates (primary, secondary, and carinar process) in the developing tooth of Lytechinus variegatus revealed by synchrotron X-ray absorption microtomography (microCT).

This paper reports the first noninvasive, volumetric study of entire cross-sections of a sea urchin tooth in which the individual calcite structural elements could be resolved. Two cross-sectionally intact fragments of a Lytechinus variegatus tooth were studied with synchrotron microCT (microcomputed tomography) with 1.66 microm voxels (volume elements). These fragments were from the plumula, that is the tooth zone with rapidly increasing levels of mineral; one fragment was from a position aboral of where the keel developed and the second was from the zone where the keel was developing. The primary plates, secondary plates, carinar process plates, prisms, and elements of the lamellar-needle complex were resolved. Comparison of the microCT data with optical micrographs of stained thin sections confirmed the identifications and measured dimensions of the characteristic microarchitectural features. The interplay of reinforcing structures (plates and prisms) was more clearly revealed in the volumetric numerical data sets than in single or sequential slices. While it is well known that the primary plates and prisms in camarodont teeth are situated to improve resistance to bending (which can be termed primary bending), the data presented provide a new understanding of the mechanical role of the carinar process plates, that is, a geometry consistent with that required in the keel to resist lateral or transverse bending of the tooth about a second axis. The increase in robustness of teeth incorporating lateral keel reinforcement suggests that the relative development of carinar processes (toward a geometry similar to that of L. variegatus) is a character which can be used to infer which sea urchins among the stirodonts are most primitive and among the camarodonts which are more primitive.

Animals↗

X-ray microCT study of pyramids of the sea urchin Lytechinus variegatus.

This paper reports results of a novel approach, X-ray microCT, for quantifying stereom structures applied to ossicles of the sea urchin Lytechinus variegatus. MicroCT, a high resolution variant of medical CT (computed tomography), allows noninvasive mapping of microstructure in 3-D with spatial resolution approaching that of optical microscopy. An intact pyramid (two demipyramids, tooth epiphyses, and one tooth) was reconstructed with 17 microm isotropic voxels (volume elements); two individual demipyramids and a pair of epiphyses were studied with 9-13 microm isotropic voxels. The cross-sectional maps of a linear attenuation coefficient produced by the reconstruction algorithm showed that the structure of the ossicles was quite heterogeneous on the scale of tens to hundreds of micrometers. Variations in magnesium content and in minor elemental constitutents could not account for the observed heterogeneities. Spatial resolution was insufficient to resolve the individual elements of the stereom, but the observed values of the linear attenuation coefficient (for the 26 keV effective X-ray energy, a maximum of 7.4 cm(-1) and a minimum of approximately 2 cm(-1) away from obvious voids) could be interpreted in terms of fractions of voxels occupied by mineral (high magnesium calcite). The average volume fraction of mineral determined for a transverse slice of the demipyramid near where it joins an epiphysis was 0.46; for a slice 3.3 mm adoral it was 0.70. Local volume fractions of mineral approached 1, and, away from resolvable voids, considerable portions of the demipyramids had volume fractions of calcite at or below approximately 0.33. MicroCT imaging of a demipyramid before and after infiltration with a high absorptivity fluid (sodium polytungstate) confirmed the determination of the volume fractions of minerals.

Animals↗

X-ray absorption microtomography (microCT) and small beam diffraction mapping of sea urchin teeth.

Two noninvasive X-ray techniques, laboratory X-ray absorption microtomography (microCT) and X-ray diffraction mapping, were used to study teeth of the sea urchin Lytechinus variegatus. MicroCT revealed low attenuation regions at near the tooth's stone part and along the carinar process-central prism boundary; this latter observation appears to be novel. The expected variation of Mg fraction x in the mineral phase (calcite, Ca(1-x)Mg(x)CO(3)) cannot account for all of the linear attenuation coefficient decrease in the two zones: this suggested that soft tissue is localized there. Transmission diffraction mapping (synchrotron X-radiation, 80.8 keV, 0.1 x 0.1mm(2) beam area, 0.1mm translation grid, image plate area detector) simultaneously probed variations in 3-D and showed that the crystal elements of the "T"-shaped tooth were very highly aligned. Diffraction patterns from the keel (adaxial web) and from the abaxial flange (containing primary plates and the stone part) differed markedly. The flange contained two populations of identically oriented crystal elements with lattice parameters corresponding to x=0.13 and x=0.32. The keel produced one set of diffraction spots corresponding to the lower x. The compositions were more or less equivalent to those determined by others for camarodont teeth, and the high Mg phase is expected to be disks of secondary mineral epitaxially related to the underlying primary mineral element. Lattice parameter gradients were not noted in the keel or flange. Taken together, the microCT and diffraction results indicated that there was a band of relatively high protein content, of up to approximately 0.25 volume fraction, in the central part of the flange and paralleling its adaxial and abaxial faces. X-ray microCT and microdiffraction data used in conjunction with protein distribution data will be crucial for understanding the properties of various biocomposites and their mechanical functions.

Animals↗

Improved high-performance liquid chromatographic method for analysis of L-carnitine in pharmaceutical formulations.

A reversed-phase high performance liquid chromatographic method for analysis of L-carnitine is described. The improved method is able to provide a high resolution between L-carnitine and crotonoylbetaine, a major impurity and degradation product, and suitable for quantitative analysis of L-carnitine in pharmaceutical formulations, such as solution, tablets, and capsules. The resolution, linearity, accuracy and reproducibility of the method are discussed.

Calibration↗

Liquid chromatographic determination of FP-21399 in plasma of patients with HIV infection.

A high-performance liquid chromatographic (HPLC) analysis method for the novel anti-HIV drug FP-21399 in human plasma was developed. The method employed the combination of organic solvent extraction and solid phase extraction. Analysis of FP 21399 and two major metabolites was achieved within 18 min using a reverse phase Puresil Cl 8 analytical column (4.6 x 150 mm, 5 microm, Waters) with a mobile phase of water-acetonitrile containing 20 mM triethylamine acetate (apparent pH 7.0). Linear gradient of mobile phase was applied as water-acetonitrile from 78:22 (v/v) to 55:45 over 8 min, and held at this ratio for the next 4 min. An ultraviolet-visible detector was operated at 265 mn from 0 to 8 min and at 600 mn from 8 min and after. The retention time of FP-21399 was 8.8 min and a linear response was observed over the concentration range 0.01 100 microg ml(-1) (r = 0.994). Lower limit of quantitation was found to be 0.01 microg ml(-1). Intra- and inter-assay precision varied in the range of 0.2 to 8% and 1-12%, respectively. The bias ranged from -17-3% for all analyses. A series of clinical plasma specimens were successfully analyzed using this method. The strategies for the method optimization on HIPLC separation and extraction procedure are discussed as well.

Anti-HIV Agents↗

Type I collagen-phosphophoryn interactions: specificity of the monomer-monomer binding.

It has been postulated that phosphophoryn (PP) molecules bind specifically to type I collagen fibrils as the key event in inducing matrix mineralization in dentin. The nature and specificity of the collagen molecule-PP interaction has been examined by rotary shadowing-electron microscopy of mixtures of native, monomeric lathyritic rat skin collagen and purified rat incisor PP. An antibody to the amino-telopeptide of the collagen alpha1(I)-chain was used to determine the N-terminal end of the collagen molecules. Solutions of collagen and PP in 0.01 M ammonium formate (+/- antibody) were mixed and spread in 70% glycerol-30% 0.01 M ammonium formate on freshly cleaved mica surfaces using the sandwich technique. After rotary shadowing with Pt and backcoating with a carbon film, the spreads were viewed in a JEOL 1200EX TEM. The PP appeared as 15-nm diameter globules, the collagen as semi-flexible 270 nm filaments. At neutral pH and low PP/collagen mixing ratios, a single interaction site was evident, centered at approximately 210 nm from the N-terminus. The binding interaction induced a local conformational change in the collagen, bending the molecule and reducing its effective length. The sequence within the collagen-PP-binding domain has a net-positive charge but contains both positively and negatively charged groups.

Amino Acid Sequence↗

Effects of lower body pressure changes on pulmonary function.

PURPOSE: During and following exercise there are a number of changes in pulmonary function, among which is a decrease in forced vital capacity (FVC). Several potential mechanisms may explain this decreased FVC, including an exercise-induced increase in thoracic blood volume. METHODS: We tested the hypothesis that altered thoracic blood volume alone, as produced by the application of 30 mm Hg lower body negative (LBNP) or positive pressure (LBPP) for 5 min, would change FVC and forced expiratory volume in 1 s (FEV1.0). Further, we tested whether the changes in pulmonary function were related to initial lung volume and whether the lower body pressure changes led to an altered lung compliance as measured by static pressure-volume curves. RESULTS: Results indicated that with LBNP, FVC, and FEV1.0 were significantly increased by approximately 0.15 L and 0.18 L, respectively. When LBPP was applied, FVC and FEV1.0 were decreased by approximately 0.18 and 0.14 L, respectively. The increase in FVC with LBNP was significantly related to the original FVC (r = 0.66, P < 0.05). There was no significant correlation between the increase in FEV1.0 and the original FEV1.0 (r = 0.48, P > 0.05). Pulmonary compliance was not changed significantly by the application of LBPP. CONCLUSIONS: These results suggest that part of the change in pulmonary function following heavy exercise is related to an increased thoracic blood volume. The lack of change in lung compliance suggests that the effect of altered thoracic blood volume is to displace air and not to change the mechanical properties of the lungs.

Adult↗

[Computer tomography of pathological neck lesions].

The introduction of high resolution computed tomography (CT) has significantly improved the quality of imaging of neck masses. Incremental dynamic scanning immediately after a quick bolus injection of contrast medium is essential in a majority of patients in order to obtain an optimum of information. This is especially true in the identification, mapping and staging of malignant lesions, which is the main indication for the examination. CT is also very sensitive, and yields detailed information about the location and extent of cystic and other benign lesions. Owing to the low attenuation of fat, the examination is very specific with respect to lipomas. CT has low specificity in the differentiation between benign and malignant lesions, and between cysts and solid tumours of the thyroid gland. In thyroid and parathyroid imaging other modalities such as ultrasound and scintigraphy are often more specific.

Head and Neck Neoplasms↗