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Biomedical subjects

T Justesen

Publications and source records attributed to T Justesen.

At least 37 records · Page 2Linked to original sources

Functional radiographic examination of the cervical spine in patients with post-traumatic headache.

The segmental extension-flexion motion of the cervical spine and the overall C1-C7 motion were measured on functional X-rays in 19 patients with post-traumatic headache and 19 age- and sex-matched controls. The extension-flexion C1-C7 motion was reduced in patients with post-traumatic headache due to reduced motion in three segments: C2-C3, C5-C6 (p less than 0.05), and C6-C7 (p less than 0.01). In both groups a negative correlation between the C1-C7 motion and age was found, but the regression coefficients were different. Only in the control group could a negative correlation between segmental motion and age be demonstrated. In the patients with post-traumatic headache a statistically significant negative correlation between the log (pain index) and the age-corrected C1-C7 motion was found (p less than 0.04). On the segmental level a negative correlation between the log (pain index) and the age-corrected C1-C2 and C5-C6 motion could be demonstrated (p less than 0.05). Regarding C6-C7 there was a tendency to negative correlation. Furthermore, a negative correlation between the frequency of associated symptoms (dizziness, visual disturbances and ear symptoms) and the age-corrected C5-C6 motion was found. Consequently the decrement of motion primarily affected C2-C3, C5-C6, and C6-C7, whereas the analysis of correlation with pain index indicated C1-C2 and C5-C6 (C6-C7) as the most important segments involved.

Adolescent↗

Trimipramine and other antipsychotics inhibit Campylobacter pylori in vitro.

A series of conventional anti-ulcer drugs, tricyclic antidepressants and neuroleptics (and some CNS non-active isomers) were tested in vitro for possible inhibition of Campylobacter pylori. These bacteria are claimed to play an etiological role in peptic ulcer disease, at least in gastritis B. While cimetidine, famotidine, ranitidine and pirenzepine were inactive, all the antipsychotic agents and their isomeric derivatives were active to various degrees with IC50 of 26-59 microM. Of special interest is trimipramine (Surmontil) that has been demonstrated to be effective against duodenal ulcers in some trials. The activity of the non-neuroleptic stereo-isomers of clopenthixol and chlorprothixene may lead to investigation in patients with peptic ulcer disease of this kind of agents. However, a firm connection between the antimicrobial activity of these compounds, their possible anti-ulcer effect and the etiological role of Campylobacter pylori in peptic ulcer disease must first be established.

Anti-Ulcer Agents↗

Campylobacter pylori in peptic ulcer disease. III. Symptoms and paraclinical and epidemiologic findings.

Only a few publications have dealt with the subjective symptoms, the paraclinical findings, or the epidemiology in relation to cultivation of C. pylori. Seventy-two patients answered a questionnaire containing questions about symptoms, dietary habits, smoking, and animal contact. C. pylori was cultivated from the biopsy specimens of 41 of these patients, and 31 were culture-negative. In addition, leukocyte count, differential count, and blood immunoglobulins were measured. In many culture-positive patients a variation in symptoms during the year was found, and symptoms had lasted more than 5 years. This was statistically significant for non-ulcer patients. In addition, we found initial abdominal pain and present vomiting to be significant features, but they did not seem to have any clinical significance. Unlike Marshall & Warren, we did not find ructus to be related to infections with C. pylori. In all other respects we found no differences between culture-negative and culture-positive patients. It was not possible to detect any descriptive variables in patients with C. pylori infections.

Adult↗

Campylobacter pylori in peptic ulcer disease. II. Endoscopic findings and cultivation of C. pylori.

Specimens from 153 consecutive patients were cultivated for C. pylori, and findings were correlated to the endoscopic findings. C. pylori was cultivated more frequently from males than from females. Culture-positive males had a high frequency of prepyloric abnormalities. No correlation between age or pH in gastric juice and cultivation of C. pylori was found. C. pylori was found significantly more often in patients with peptic ulcer and/or duodenitis than in patients with normal endoscopic findings. No differences could be detected between patients with gastritis or esophagitis and patients with normal endoscopic findings. C. pylori was found most frequently in the antral part of the stomach. It was cultivated significantly more often from patients with duodenal abnormalities than from patients with normal endoscopic findings. In less than half of the culture-positive patients with duodenal abnormalities we cultivated C. pylori from duodenal specimens. This study also showed C. pylori in esophageal specimens, which has not been previously described. Our results suggest that cultivation of C. pylori from duodenal specimens or gastric fluid samples gives no additional information beyond that obtained from the cultivation of antral biopsy specimens. It is our opinion that C. pylori, at least in some cases, may be a secondary infection.

Adolescent↗

Radiographic findings in patients with clinical Tietze syndrome.

Thirteen patients with similar painful tender swelling in the region of the sternocostal joint (SCJ) are reported. X-ray tomography revealed changes which might explain the swelling in 11 patients. Three patients had anatomical variants of the sternum. One of these and a further two patients had marginal osteophytes at the affected SCJ, as signs of osteoarthrosis. Six patients with psoriasis, pustulosis palmoplantaris, or psoriasis in the family had past or present arthritis of the involved SCJ or the manubriosternal joint. Tomography was found to be a useful confirmatory examination in patients with clinical Tietze syndrome.

Adult↗

Campylobacter pyloridis in peptic ulcer disease. I. Gastric and duodenal infection caused by C. pyloridis: histopathologic and microbiologic findings.

In this study 153 patients with dyspepsia were biopsied in the gastric antrum and duodenum. All specimens were investigated histopathologically and microbiologically for the presence of Campylobacter pyloridis, and the type of inflammation was recorded in accordance with Morson's criteria. C. pyloridis was found beneath the mucus close to the epithelial cells and mostly in connection with granulocytic infiltration (active gastritis). C. pyloridis was cultured from all of 10 patients with histologically active gastritis and active duodenitis, in 86% of 64 patients with active gastritis and morphologically normal duodenum, and in only 5% of 79 patients without morphologic gastric and duodenal changes. The close relation between active gastritis and C. pyloridis shows that C. pyloridis plays an important role in gastric inflammation, as it fulfils the criterion for a localized bacterial infection.

Adolescent↗

Bile acid malabsorption in patients with an ileum reservoir with a long efferent leg to an anal anastomosis.

Biliary metabolism in 11 patients with ileum reservoirs with anal anastomosis and a long efferent leg was studied. Eleven healthy persons served as controls. A significantly higher excretion of bile acids was found in the patients, but they seemed to have a normal cholic acid pool size. The bile acids excreted were cholic acid and chenodeoxycholic acid, the so-called primary bile acids, for more than 90%, whereas the normal controls mainly excreted secondary bile acids (deoxycholic acid and lithocholic acid). Fat excretion was generally not increased in the group but was above normal in two patients. Vitamin B12 absorption was subnormal in two patients and was not correlated to bile acid excretion. Bile acid excretion was not correlated to the weight of feces. The bacterial flora was more feces-like than would have been expected from a normal terminal ileum but was correlated neither to the bile acid excretion nor to the quantity of feces. We conclude that the patients showed dysfunction of the terminal ileum with regard to biliary acid absorption comparable to that found in patients with partial ileal resections.

Adult↗

Diagnosis of bacterial overgrowth of the small intestine. Comparison of the 14C-D-xylose breath test and jejunal cultures in 60 patients.

Sixty consecutive patients suspected of having bacterial overgrowth of the small intestine (BOG) had aerobic and anaerobic bacterial cultures made of fasting upper jejunal fluid and also a 14C-D-xylose breath test (XBT). Culture-proven BOG was present in 23 patients. In another 15 patients the presence of BOG was ruled out (diagnoses: irritable bowel syndrome, 8; chronic diarrhoea, 6; and lactose malabsorption, 1). These patients were used as controls. The other 22 of the 60 patients could not be placed in either group owing to the presence of factors known to predispose for BOG; none of them had abnormal jejunal cultures, but several had strong clinical suspicion of BOG. An abnormal XBT, defined as values exceeding upper 90% confidence limits (upper range) of the 15 patient control values within a 4-h period, was observed with the following frequencies in the 23 patients with BOG: after 60 min, 35%; after 120 min, 44%; after 180 min, 61%; and after 240 min, 65%. An abnormal XBT was observed in 41% of the 22 patients with normal jejunal cultures but with predisposition for, and clinical suspicion of, BOG. It is concluded that, compared with a relevant control material, the XBT tends to be rather insensitive and that a negative outcome of jejunal cultures is inadequate to exclude the presence of BOG.

Adult↗

Wound infection rates after intraincisional plus systemic antibiotic prophylaxis in an animal model.

The effect of intraincisional application of antibiotics in addition to systemic antibiotic prophylaxis was evaluated in a randomized blind study using a guinea pig model of surgical wound infection. Wounds were contaminated with 10(7) Escherichia coli plus 10(8) Bacteroides fragilis. Wound infection was defined as accumulation of pus draining spontaneously or after opening the wound. Systemic antibiotic prophylaxis with gentamicin plus clindamycin significantly reduced the wound sepsis rate from 83% in the control group to 20% in the treated group (p less than 0.001). Intraincisional application of antibiotics in addition to systemic prophylaxis did not further reduce the rate of wound sepsis (p greater than 0.8).

Animals↗

Wound infection rates following preoperative versus intraoperative commencement of antibiotic prophylaxis.

The effect of antibiotic prophylaxis initiated one hour prior to contamination or at the time of contamination was evaluated in a randomized blind study using a guinea pig model of surgical wound infection. Would infection, defined as accumulation of pus draining spontaneously or after opening of the wound, developed in 135 guinea pigs after intraincisional contamination before wound closure with 10(7) Escherichia coli plus 10(8) Bacteroides fragilis. Antibiotic prophylaxis with gentamicin plus clindamycin significantly reduced the wound sepsis rate from 82% in the control group of 61 animals to 19% in the two treated groups of 68 and 67 animals (p less than 0.001). However, the timing of antibiotic prophylaxis did not influence wound sepsis rates, rectal temperature during the postoperative period, or bacterial recovery from wound infections.

Animals↗

Rapid identification of Capnocytophaga isolated from septicemic patients.

Four Capnocytophaga strains from blood cultures of immunocompromised patients with malignant disease and the type strains of three Capnocytophaga species were examined and compared to strains representing five other genera that are hard to differentiate from Capnocytophaga. With three rapid identification methods, negative catalase and oxidase reactions and positive ONPG assay, Capnocytophaga was easily separated from Eikenella corrodens, Actinobacillus actinomycetemcomitans, Cardiobacterium hominis, and CDC group DF-2. Haemophilus aphrophilus was excluded by leucine, valine and cystine arylamidase and alpha-glucosidase reactions (API ZYM). Further confirmatory reactions constituted gelatin hydrolysis, haemin requirement, and carbohydrate and esculin breakdown. Although rapid identification of Capnocytophaga to the genus level was feasible, differentiation on a species level proved impossible.

Capnocytophaga↗

Intraincisional antibiotics in laparotomy wounds.

Concentrations of ampicillin after intraincisional instillation in laparotomy wounds were measured in ten patients undergoing appendectomy. Ampicillin, 1 gm, was instilled under the fascia and 1 gm in the subcutaneous space during wound closure. Wound secretion was collected every two hours during the first 24 postoperative hours by cannulation of a fine perforated drain placed in the subcutaneous space. Ampicillin was determined by a disk diffusion method. During the first eight hours the median concentration of ampicillin in wound secretion exceeded 1000 microgram/ml; 14 hours and 20 hours after wound closure the median concentrations were 73 and 14 microgram/ml, respectively. The effect of ampicillin in high concentrations on "resistant" strains of Bacteroides fragilis was demonstrated in an in vitro experiment. It is concluded that in colorectal surgery the effect on wound sepsis of intraincisional antibiotics as an addition to systemic antibiotic prophylaxis should be evaluated in a clinical trial.

Administration, Topical↗

Normal cultivable microflora in upper jejunal fluid in children without gastrointestinal disorders.

Bacteriological studies of uncontaminated upper jejunal fluid were performed in 51 Danish children without gastrointestinal disorders. Thirty-seven percent of the samples were sterile [less than 10(1) colony-forming units (CFU)/ml]. In 25% of the cases, the total number of microorganisms exceeded 10(5) CFU/ml. The microorganisms isolated most frequently were: Streptococcus, sp. ("Viridans group"), Veillonella parvula, Hemophilus parainfluenzae, Lactobacillus, sp., Corynebacterium, sp., Actinomyces, sp., Bacteroides, sp., and Hemophilus influenzae, each found in more than 10% of the children. The upper range for the number of microorganisms isolated exceeded 10(5) CFU/ml for most of the species isolated of which the vast majority belonged to an "oral type" of flora. Enterococci were isolated in small numbers in three children, and Enterobacteriaceae were not found.

Actinomyces↗

The normal cultivable microflora in upper jejunal fluid in healthy adults.

Bacteriological studies of uncontaminated upper jejunal fluid were performed in 85 normal subjects. Fifty-three per cent of the samples were sterile (less than 10(1) CFU/ml). In 10% of the cases the total number of microorganisms exceeded 10(5) CFU/ml. The main groups of microorganisms isolated were Streptococcus sp ('Viridans group'), Lactobacillus sp., Veillonella parvula, Actinomyces sp., Haemophilus sp., Corynebacterium sp., and Candida albicans, each found in more than 10% of the subjects. Only the Streptococcus sp. exceeded 10(5) CFU/ml, and enterobacteria were found in 5% of the subjects, the number not exceeding 10(3) CFU/ml. No other typical members of the lower gastrointestinal tract were isolated. The number of subjects harbouring bacteria and the distribution of bacterial species were the same in both sexes and in different age groups.

Adolescent↗

Multiresistant lipophilic corynebacteria from clinical specimens. Biochemical reactions and antimicrobial agents susceptibility.

Ninety-seven strains of clinically isolated Corynebacterium strains, probably identical with Corynebacterium JK, are described especially in regard to growth in relation to different lipid substances. The corynebacteria formed a homogeneous group of strict aerobic slow-growing, catalase-positive, urease-and-nitrate-negative typical coryneform rods. Acid was produced from glucose and maltose. Growth was stimulated in the presence of different lipid substances and lipodependence was suggested by satellite growth only around oleic acid drops on otherwise lipid-depleted agar plates. Generally the isolated corynebacteria were resistant to clinically achievable concentrations of penicillins, cephalosporines and aminoglucosides but uniformly sensitive to vancomycin and rifamycin.

Anti-Bacterial Agents↗