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Biomedical subjects

T Jacobsen

Publications and source records attributed to T Jacobsen.

At least 19 recordsLinked to original sources
PubMed1996

[Diverticulitis of the colon. Diagnosis and treatment illustrated by a patient material].

During the period 1985-92, 181 patients were treated at Aker Hospital for diverticulitis of the colon. 106 patients (59%) were treated conservatively, and 75 (41%) were operated on for complications. The mortality among the patients treated conservatively was 4.7%. 47 patients underwent operation in the acute stage, most often for perforation or intestinal obstruction, and the most frequent operation was the Hartmann procedure. 28 patients had an elective operation, the most common indication being a fistula from the colon. In this group the operation was usually resection with anastomosis. After acute operation, 17 patients (36%) experienced surgical complications, and the mortality was 12.8% (six patients). After elective operation the morbidity was low (2/28), and the mortality was nil. Our preferred principle for acute surgery for diverticulitis is colonic resection. This eliminates the source of contamination, and allows debridation and cleansing of the peritoneum.

Adult↗
PubMed1995

Comparison of lipases from different strains of the fungus Geotrichum candidum.

The type A lipase and the cis-9 18:1 specific type B lipase of different strains of Geotrichum candidum were compared. Comparing the enzyme activity of crude lipase preparation and purified type A and type B lipases and the protein pattern of these preparations in denaturing polyacrylamide gel electrophoresis (SDS-PAGE) revealed that the specific activity for cis-9 18:1 fatty acids was related to the content of the type B lipase. Tandem-crossed immunoelectrophoresis was used to demonstrate immunological identity between type A and type B lipase of G. candidum ATCC 66592. Partial immunological identity was observed between type B lipase of this strain and type A lipase of G. candidum ATCC 34614 and two commercial crude G. candidum lipase preparations (Amano and Biocatalyst), i.e., the type B lipase of G. candidum ATCC 66592 had immunogenic epitopes which are not present on the other lipases. Enzymatic deglycosylation of the lipases did not alter this pattern. After partial proteolysis of purified type A and type B lipases of G. candidum ATCC 66592, Amano and Biocatalyst, no difference between the type A lipase of the three strains was observed in SDS-PAGE. For all strains the type B lipase exhibited a distinctly different peptide pattern to that of the type A lipase. In addition, the type B lipase of G. candidum ATCC 66592 differed from the type B lipase of Amano and Biocatalyst by having an additional peptide band. The results indicate that the G. candidum ATCC 66592 should be considered a distinct strain regarding the protein chemical characteristics of its type B lipase, whereas the two commercial lipase preparations appear to be very similar.

Geotrichum↗
PubMed1995

Some effects of water on dentin bonding.

OBJECTIVES: The goals of this study were to determine how: 1) the bond strengths of hydroxyethylmethacrylate (HEMA)-based dentin primers are affected by different solvents (water or acetone), 2) the application time of these primers affect the bond strength, and 3) the conversion of water contaminated bonding resins. METHODS: HEMA (35%), mixed with water or acetone, was placed on moist dentin for 30 or 120 s, dried, covered with a bonding resin, and light-cured. Composite cylinders were bonded to these surfaces, and the shear bond strength was determined after 30 d of water storage at 37 degrees C. The conversion of bonding resins containing 0.05, 0.1, 0.2, 0.4 and 0.8 mL water per mL of bonding resin was determined with FTIR. RESULTS: The two acetone groups gave significantly (p<0.5) higher bond strength values (sigma 30s=22.2 +/- 2.1 MPa and sigma 120s=21.5 +/- 3.2 MPa) than the two water groups (sigma 30s=7.0 +/- 3.3 MPa and sigma 120s=16.2 +/- 4.8 MPa). In contrast to the acetone-based primer, the water-based primer improved its bond strength with increased priming time without reaching that of the two acetone groups. The conversion of the bonding resin was 53.5%, which decreased to approximately 25% when 0.2 mL or more water was added per mL resin. SIGNIFICANCE: Compared to acetone, water is inferior as a solvent for HEMA-based dentin primers and gives both lower bond strength and requires longer priming time than acetone. A possible explanation of these results is the ability of water to interfere with the polymerization of the resin systems.

Acetone↗
PubMed1995

Case study: is selective mutism a manifestation of dissociative identity disorder?

Selective mutism is a rare psychiatric disorder that usually has its onset in early childhood. This case study describes a patient in whom selective mutism developed in adolescence. It was later discovered that he had dissociative identity disorder. The study documents his history, which included violence, abuse, and threats to keep silent. The study suggests that in cases presenting with significant trauma or abuse, selective mutism may be a manifestation of dissociative identity disorder.

Adolescent↗
PubMed1994

Surfactant therapy and nasal continuous positive airway pressure for newborns with respiratory distress syndrome. Danish-Swedish Multicenter Study Group.

BACKGROUND: In southern Scandinavia most babies with respiratory distress syndrome are initially treated with nasal continuous positive airway pressure. We performed a multicenter trial to investigate whether the addition of a single dose of porcine surfactant administered during a short intubation before the occurrence of serious deterioration could reduce the subsequent need for mechanical ventilation. METHODS: We randomly assigned 35 infants with moderate-to-severe respiratory distress syndrome to surfactant therapy (Curosurf, 200 mg per kilogram of body weight) plus nasal continuous positive airway pressure and 33 infants to nasal continuous positive airway pressure alone. The study was not blinded. The indications for mechanical ventilation were a ratio of arterial to alveolar oxygen tension of less than 0.15, severe apneic attacks, or both. RESULTS: Six hours after randomization, when the median age of the babies was 18 hours, the mean ratio of arterial to alveolar oxygen tension was 0.37 in the surfactant-treated babies, as compared with 0.25 in the controls (P < 0.001). The need for subsequent mechanical ventilation was reduced with surfactant therapy (to 43 percent of the surfactant-treated babies as compared with 85 percent of the controls; P = 0.003). When 17 infants with ratios of arterial-to-alveolar oxygen tension of less than 0.15 at randomization were excluded, the need for mechanical ventilation was still significantly reduced in the surfactant-treated group (to 33 percent [9 of 27 babies], as compared with 83 percent [20 of 24 babies] in the control group; (P < 0.001). After 28 days, two of the surfactant-treated babies had died, as compared with five of the control babies. CONCLUSIONS: In babies with moderate-to-severe respiratory distress syndrome treated with nasal continuous positive airway pressure, a single dose of surfactant reduced the need for subsequent mechanical ventilation.

Biological Products↗
PubMed1994

[Neonatal cancer in Denmark 1943-1985].

In order to describe the incidence, distribution and prognosis of neonatal cancer, 76 cases (44 boys, 32 girls) of cancer in the first 28 days of life were identified in the Danish Cancer Registry within the period 1943-85. All cases were re-evaluated and the International Classification of Disease for Oncology (ICD-O) code was applied. The incidence is calculated to 2.38 (1.88-2.98) cases per 100,000 births. The most common tumour was neuroblastoma (26%) followed by leukaemias (16%), soft tissue sarcomas (14%) and brain tumours (11%). The five year survival rate was 25% (15.1-39.0) with the highest survival rate among soft tissue sarcomas (55%) and neuroblastomas (25%) and the lowest among leukaemias and brain tumours (0). Eighteen per cent of the cases were incidental findings. Two cases of secondary malignancy were identified.

Age Factors↗
PubMed1994

Complications during the introduction of laparoscopic cholecystectomy in Norway. A prospective multicentre study in seven hospitals.

OBJECTIVE: To assess the morbidity of laparoscopic cholecystectomy since its introduction in Norway in the Autumn of 1990. DESIGN: Postal collection of prospectively collected data. SETTING: Practices of 26 surgeons in 7 district and university hospitals. SUBJECTS: 527 patients who underwent laparoscopic cholecystectomy. INTERVENTIONS: 133 patients (25.5%) had endoscopic retrograde cholangiopancreatography before operation, and two had cholangiograms during operation; dissection was by electrocautery in 490 patients and by laser in 37. MAIN OUTCOME MEASURES: Morbidity, number converted to open operation, and number who required reoperation. RESULTS: There were no deaths and a total of 70 complications (13.3%), 8 of which were after laser dissection. There were 59 local complications (11.2%) and 11 general (2.1%); 12 patients (2.3%) required reoperation for bleeding (n = 5), biliary leak (n = 4), and incisional hernia (n = 3). One had a retained stone in the common duct. 42 were converted to open operation (8.0%), 11 because of complications (bleeding, n = 6; damage to the bile duct, n = 3; and bowel perforation, n = 2). Of the 28 patients with acute cholecystitis 5 (17.9%) had to be converted to open operations and 7 (25.0%) developed complications. 2 of these patients had bile duct injury. CONCLUSION: The morbidity during the introductory period of laparoscopic cholecystectomy in Norway is higher than that reported elsewhere, indicating that the risk of complications is increased during the learning period.

Bile Ducts↗
PubMed1993

Morphology of coupling sites between bonding agents and dentine in vivo and in vitro.

In spite of the unclear relationship between in vitro and in vivo conditions, the majority of dentine bonding agent investigations are carried out in vitro. The purpose of this SEM study was to compare micromorphologically the bonding sites between dentine and seven resin bonding systems, which were applied either in vivo or in vitro on freshly cut dentine in similar locations on contralateral premolar teeth scheduled for extraction for orthodontic reasons. The morphology of the bonding sites was investigated on samples fractured perpendicularly to the bonding interface following superficial decalcification and deproteinization of the dentine. For six of the seven systems studied a resin-impregnated dentine layer was identified. This hybrid zone was very similar on specimens prepared in vivo and in vitro.

Adolescent↗
PubMed1993

"Minitouch" treatment of very low-birth-weight infants.

In a cohort study with historical controls of non-asphyxiated very low-birth-weight infants (birth weight < or = 1500 g and gestational age < 33 completed weeks), we evaluated the use of a "minitouch" regime for stabilization after birth and treatment of respiratory distress. This combination of early (prophylactic) treatment with nasal continuous positive airway pressure and minimal handling was introduced as a routine in our Department in 1986. We compared infants born in 1987 and in 1985, when ventilator treatment was used initially in all infants with progressing respiratory distress. The frequency of mechanical ventilation was reduced significantly from 76% in 1985 to 35% in 1987 (p = 0.00001). This reduction reflected the smaller number of infants who received ventilator treatment for less than one week, whereas the frequency of long-term ventilator treatment remained unchanged. Intracranial haemorrhage grade II-IV was reduced from 49% in 1985 to 25% in 1987 (p = 0.01). Mortality rate, average duration of hospitalization, number of infants with pneumothorax, patent ductus arteriosus, need for oxygen at 28 days and number of surviving infants with handicap did not differ significantly between the two study periods. Septicaemia was diagnosed in 16% of the infants in 1987 versus 7% in 1985 (p = 0.045). This difference coincided with an increased use of total parenteral nutrition (18% in 1987 versus 3% in 1985, p = 0.007). We conclude that the minitouch regime prevents progression of respiratory distress, reduces the need for ventilator treatment and is a safe and convenient alternative to mechanical ventilation in preterm infants with mild respiratory problems.(ABSTRACT TRUNCATED AT 250 WORDS)

Cerebral Hemorrhage↗
PubMed1992

[Surfactant treatment of newborn infants with respiratory distress syndrome primarily treated with nasal continuous positive air pressure. A pilot study].

In this pilot study, Curosurf (200 mg/kg) was administrated to 34 patients with the respiratory distress syndrome in nasal-CPAP therapy with FiO2 requirements greater than 0.60 and/or TcPCO2 greater than 8 kPa. The surfactant was instilled during a short period of intubation or in a few cases via an intratracheal catheter (Ch. 6). The age of the patients on surfactant treatment ranged from two to 72 hours. Eighteen patients could be maintained on nasal-CPAP after treatment with Curosurf and only a few complications were seen in these infants. The other 16 patients subsequently required artificial ventilation and had a higher incidence of pulmonary and extrapulmonary complications. On the basis of these observations, we plan a randomized trial to investigate whether, administration of surfactant reduces the need for ventilator treatment and improves the odds for uneventful recovery in this category of patients.

Biological Products↗
PubMed1992

[Treatment of severe respiratory distress syndrome with surfactant].

The first Danish experience of treatment of the respiratory distress syndrome (RDS) in preterm infants with exogenous surfactant is described. Fifteen infants with birthweights of 645-1,865 g and gestational ages of 25-32 weeks, all receiving artificial ventilation with at least 60% oxygen for severe RDS, were treated with purified porcine surfactant (Curosurf) within the first 28 hours of life. Pulmonary function improved immediately in all of the infants. Four infants (27%) died, four (27%) developed bronchopulmonary dysplasia (pulmonary fibrosis) and two (13%) had late neurological sequelae. These preliminary results are considered to be promising and they are in complete agreement with the results of randomised, controlled investigations from abroad. Systematic registration is, however, still necessary.

Biological Products↗
PubMed1992

[Ogilvie syndrome].

Ogilvie's syndrome, or acute colonic pseudo-obstruction, is clinically impossible to differentiate from mechanical colonic ileus. Ogilvie's syndrome is associated with several conditions but the most common associated factor is surgery. Earlier, coecostomi or colostomy was the treatment of choice but most experts will agree that, although several methods of treatment have been proposed, the one now to be preferred is deflation by a colonoscope.

Aged↗
PubMed1992

Acute changes in cerebral oxygenation and cerebral blood volume in preterm infants during surfactant treatment.

Following administration of surfactant a marked depression in aEEG activity occurs for about 10 minutes; the mechanism of this depression is unknown. In view of this, twenty-nine preterm infants were investigated with near infrared spectroscopy (NIRS) to evaluate rapid changes in total cerebral haemoglobin concentration and cerebral oxyhaemoglobin concentration during rescue treatment with natural surfactant. During surfactant instillation there was a short-lasting hypoxaemia as demonstrated by pulseoximetry as well as a considerable fall in arterial blood pressure. With NIRS, tissue hypoxia was demonstrated by a drop in cerebral oxyhaemoglobin concentration. The marked drop in arterial blood pressure occurring immediately following surfactant was not matched by a drop in total cerebral haemoglobin concentration. This suggests that cerebral blood volume and hence cerebral blood flow was maintained. In the following minutes there was an improvement in cerebral oxygenation as indicated by the rise in cerebral oxyhaemoglobin concentration in nearly all the infants.

Birth Weight↗
PubMed1992

Separation and characterization of 61- and 57-kDa lipases from Geotrichum candidum ATCC 66592.

Two lipolytic proteins (61 and 57 kDa) present in a Sephadex G-100 fraction of extracellular lipase from Geotrichum candidum ATCC 66592 were separated using high-performance liquid chromatography. Crossed electrofocusing immunoelectrophoresis was used to demonstrate that the 61-kDa lipase fraction contained two forms of lipase with pI 4.5 and 4.7. However, when deglycosylated with endoglycosidase H, the two forms gained an identical pI, 4.6. The 57-kDa lipase fraction contained one form of lipase with pI close to 4.5. Although the 61- and 57-kDa lipases were immunologically identical, the substrate specificity differed. Thus, the 61-kDa lipase hydrolysed palmitic acid methyl ester at an initial velocity of hydrolysis that was 60% of the initial velocity of hydrolysis of oleic acid methyl ester, whereas the 57-kDa lipase hydrolysed palmitic acid methyl ester at an initial velocity of hydrolysis that was only 7% of the initial velocity of hydrolysis of oleic acid methyl ester.

Chromatography, High Pressure Liquid↗