[Intercostal tumors: diagnostic pitfalls].
Explore the source record for details and available documents.
Adult↗
Biomedical subjects
T Niemann
Publications and source records attributed to T Niemann.
Survival trends among Danish patients undergoing coronary angiography for known or suspected ischaemic heart disease: a population based follow up study, 1992-2000.
OBJECTIVE: To determine, from population based clinical data, changes in the survival of Danish patients examined by coronary angiography for known or suspected ischaemic heart disease (IHD) during the 1990s. DESIGN: Follow up study. SETTING: The departments of cardiology at Rigshospitalet, Copenhagen University Hospital, and Skejby Hospital, Aarhus University Hospital, Denmark. PATIENTS: Patients with IHD (n = 7021) who underwent first time coronary angiography in 1992, 1996, or 2000. MAIN OUTCOMES MEASURES: Three year survival was compared between cohorts and with that of the general population. Cox proportional hazards regression was used to estimate mortality ratios adjusted for differences in patient characteristics. RESULTS: Survival improved substantially--for example, adjusted mortality ratio was 0.69 (95% confidence interval (CI) 0.55 to 0.87) when comparing patients from 2000 with patients from 1992. The absolute standardised survival rates after three years of follow up were 87.1% (95% CI 85.4% to 88.8%), 89.9% (95% CI 88.5% to 91.3%), and 91.2% (95% CI 90.3% to 92.1%) among patients examined in 1992, 1996, and 2000, respectively. The improvement was not explained by the improvement in overall survival in the general population during the study period. CONCLUSIONS: The survival of Danish patients with known or suspected IHD appears to have improved substantially during the 1990s.
Adult↗
Prognostic impact of different regional referral practices for interventional investigation and coronary treatment after exercise testing: a population-based 5-year follow-up study.
OBJECTIVE: To examine the association among different centres' referral practices for coronary angiography (CAG) after exercise testing, with 1- and 5-year outcomes. DESIGN: Observational population-based cohort study. SETTING: All 10 hospitals and six private practising consultants in Aarhus and Ringkjoebing counties (900 000 inhabitants), Denmark. SUBJECTS: All patients who in 1996 had an abnormal bicycle exercise test (n = 736). MEASUREMENTS: Referral for CAG, coronary intervention, cardiovascular and all-cause mortality, and myocardial infarction (MI). RESULTS: As an immediate consequence of the exercise test, 60.7% of subjects were referred for CAG. Based on the centres' fraction of patients referred for CAG, three categories of centres were defined: low (<33%), intermediate (33-66%) and high (>66%). A low compared with a high referral fraction was associated with a similar 5-year mortality and MI ratio [all-cause/cardiovascular mortality rate ratio (RR) = 1.33, 95% confidence interval (CI): 0.45-3.92/RR = 0.62, 95% CI: 0.25-1.57; and MI RR = 0.92, 95% CI: 0.45-1.86]. The same was found for an intermediate compared with a high fraction (all-cause/cardiovascular mortality RR = 0.92, 95% CI: 0.49-1.72/RR = 0.74, 95% CI: 0.42-1.33; and MI RR = 1.07, 95% CI: 0.68-1.70). Estimates were about the same after 1 year of follow-up with no major differences among centres in mortality or MI. CONCLUSIONS: Centres' different referral practices for interventional investigation and treatment were not associated significantly with short-term or long-term mortality or MI among patients with an abnormal exercise test.
Comorbidity↗
Differences in therapeutic consequences of exercise testing between a rural and an urban Danish county: population based study.
Explore the source record for details and available documents.
Angina Pectoris↗
Ovarian 'tumor' of the adrenogenital syndrome: the first reported case.
We report the case of a 36-year-old woman with congenital adrenal hyperplasia from 21-hydroxylase deficiency who had been receiving replacement therapy with corticosteroids since birth. At the age of 35 years, she developed abrupt aggravation of her virilizing symptoms and underwent an adrenalectomy and partial left oophorectomy. Persistent virilization and high testosterone levels led to right oophorectomy and completion left oophorectomy 6 months later. Each adnexa contained ovarian or paraovarian soft brown masses that on microscopic examination were identical to the testicular tumor of the adrenogenital syndrome. This represents the first reported case of this pathology (well known in the testis) in the ovary.
Adrenal Hyperplasia, Congenital↗
Epigenetic PTEN silencing in malignant melanomas without PTEN mutation.
A tumor suppressor gene at 10q 23.3, designated PTEN, encoding a dual specificity phosphatase with lipid and protein phosphatase activity, has been shown to play an important role in the pathogenesis of a variety of human cancers. Germline mutations in PTEN cause Cowden syndrome (CS), which is characterized by multiple hamartomas and a high risk of breast and thyroid cancers. Frequent loss of heterozygosity at 10q is found in both early and advanced-stage sporadic melanomas; however, mutations or deletions in PTEN are detected mainly in melanoma cell lines. In this study, we examined PTEN expression in 34 unselected sporadic melanomas (4 primary melanomas, 30 metastases) using immunohistochemistry and correlated this with the results of structural studies of this gene. Immunostaining of 34 melanoma samples revealed no PTEN expression in 5 (15%) and low PTEN expression in 17 (50%), whereas the rest of the tumors (35%) had high levels of expression. Hemizygous deletion was found in 32% of the tumors but neither intragenic PTEN mutation nor biallelic deletion was found in any of the samples. Of the 5 melanomas showing no PTEN expression, 4 had no mutation or deletion of PTEN. Of the 13 tumors having weak PTEN immunoreactivity and informative loss of heterozygosity results, 6 had evidence of hemizygous allelic loss of PTEN while the remaining 7 had intact PTEN. These results strongly support PTEN as a major tumor suppressor on 10q involved in melanoma tumorigenesis and suggest an epigenetic mechanism of biallelic functional inactivation not previously observed in other cancers where PTEN might be involved.
DNA Mutational Analysis↗
Regional variations in the use of diagnostic coronary angiography. A one-year population-based study of all diagnostic coronary angiographies performed in a rural and an urban Danish county.
The aim of this study was to monitor coronary angiography activity and results, and to evaluate indications and treatment consequences using regional hospital registers and case records in the rural county of Ringkjøbing and urban county of Aarhus The study included all patients who had undergone a coronary angiography during 1996. For women, there were 606 (rural) and 1296 (urban) coronary angiographies per one million inhabitants (p < 0.0001) and for men, 1884 (rural) and 3051 (urban) coronary angiographies per one million inhabitants (p < 0.0001). In both counties the age distribution of the women examined was the same as that for the men. The angiographic rates were the same in the two counties for patients examined for valvular heart disease and severe arrhythmias. For patients with ischaemic heart disease, the angiographic rate for rural patients was two to three times lower than that for urban patients (p < 0.01). Revascularization procedures were performed in 39% (rural) and 40% (urban) of the examined women (NS) and 66% (rural) and 59% (urban) of the examined men (p < 0.05). Despite wide regional differences in coronary angiography activity, angiography was deployed to the same extent for examination of patients with valvular and severe arrhythmia heart disease. For patients examined for ischaemic heart disease, angiography activity was considerably lower in the rural area. The female patients had a higher frequency of normal coronary angiograms than the male patients.
Adult↗
Opioid treatment of painful chronic pancreatitis.
BACKGROUND: Abdominal pain is the dominant symptom in 50-75% of patients with chronic pancreatitis, often requiring opioid analgesics. Fentanyl, a potent synthetic opioid, can be administered percutaneously at a constant dose and is claimed to have fewer systemic side effects. AIM: To evaluate transdermal fentanyl plaster versus sustained release morphine tablets as analgesic treatment of painful chronic pancreatitis. METHODS: In an open randomized crossover trial, 18 patients were included. The treatment period was 4 wk for each drug. All patients had immediate-release morphine tablets as rescue medication. RESULTS: The dosage of transdermal fentanyl had to be increased on average 50% over that indicated by the manufacturer. When this was done and rescue medication was secured, no difference between the two drugs in primary endpoint or patient preference was observed. There was also no difference in the secondary endpoints, pain control, and quality of life. However, skin side effects, mostly mild, occurred in 44% of the patients during treatment with transdermal fentanyl, and the mean daily dose of immediate release morphine was significantly higher during the transdermal fentanyl period than during the sustained-release morphine period (30.7 mg vs. 14.7 mg [p < 0.01]). CONCLUSION: When given in an appropriate dose, transdermal fentanyl might be useful for treatment of some patients with painful chronic pancreatitis, e.g., when tablet ingestion is difficult. However, the dosage often has to be increased above that recommended by the manufacturer. The need of rescue morphine is considerable and skin side effects often occur. Transdermal fentanyl is, therefore, not the ideal first-choice analgesic in patients with painful chronic pancreatitis.
Administration, Cutaneous↗
Ocular responses to radial optic flow and single accelerated targets in humans.
Self-movement in a structured environment induces retinal image motion called optic flow. Optic flow on one hand provides information about the direction of self-motion. On the other hand optic flow presents large field visual motion which will elicit eye movements for the purpose of image stabilization. We investigated oculomotor behavior in humans during the presentation of radial optic flow fields which simulated forward or backward self-motion. Different conditions and oculomotor tasks were compared. In one condition, subjects had to actively pursue single dots in a radial flow pattern. In a second condition, subjects had to pursue single dots over a dark background. These dots accelerated or decelerated similar to single dots in radial optic flow. In a third condition, subjects were asked to passively view the entire optic flow stimulus. Smooth pursuit eye movements with high gain were observed when dots were actively pursued. This was true for single dots moving over a homogeneous background and for single dots in the optic flow. Passive viewing of optic flow stimuli evoked eye movements that resembled an optokinetic nystagmus. Slow phase eye movements tracked the motion of elements in the optic flow. Gain was low for simulated forward self-motion (expanding optic flow) and high for simulated backward movement self-motion (contracting optic flow). Thus, voluntary pursuit and passive optokinetic responses yielded different gain for the tracking of elements of an expanding optic flow pattern. During passive viewing of the optic flow stimulus, gaze was usually at or near the focus of radial flow. Our results give insights into the oculomotor performances and needs for image stabilization during self-motion and in the role of gaze strategy for the detection of the direction of heading.
Eye Movements↗
Malignant rhabdoid tumor of the uterine corpus.
Explore the source record for details and available documents.
Female↗
The influence of stationary and moving textured backgrounds on smooth-pursuit initiation and steady state pursuit in humans.
We investigated the effects of stationary and moving textured backgrounds on the initiation and steady state of ocular pursuit using horizontally moving targets. We found that the initial eye acceleration was slightly reduced when a stationary textured background was employed, as compared to experiments with a homogeneous background. When a moving textured background was introduced, the initial eye acceleration was significantly larger when the target and the background moved in opposite directions than when the target and the background moved in the same direction. The use of stationary and moving textured backgrounds resulted in comparable effects on the initial eye acceleration when they were presented either as a large field or as a narrow, horizontal small field, only covering the trajectory of the target. Moreover, small-field stationary backgrounds slightly reduced the eye velocity during steady state pursuit. A small-field background moving in the opposite direction to the target distinctly reduced eye velocity, while a target and a background moving in the same direction sometimes even improved pursuit performance, when compared with a homogeneous background. The influences of small-field textured backgrounds on steady state pursuit were comparable with those of large-field backgrounds in both stationary and moving conditions.
Adult↗
Motion processing for saccadic eye movements during the visually induced sensation of ego-motion in humans.
During ego-motion an observer is often faced with the task of controlling his heading direction while simultaneously registering the movement of objects in order to avoid possible obstacles. Psychophysical experiments have shown that the detection of moving objects is impaired by concurrent ego-motion. We investigated the interaction between ego-motion and object-motion by examining the latencies of saccades executed to moving targets under a visually induced sensation of ego-motion. Saccadic latencies increased during this sensation, with a global or non-retinotopic effect of optic flow on motion detection. Furthermore, separating stereoscopically the moving target and the optic flow into foreground and background, respectively, still resulted in increased latencies. We propose that an inhibitory influence of the perception of self-motion exists on the perception of object-motion. These results support a model of space constancy which strives to create a stable world during locomotion.
Adult↗
Helicobacter pylori infection in patients with chronic pancreatitis and duodenal ulcer.
BACKGROUND: The prevalence of duodenal ulcer is high in patients with chronic pancreatitis. Patients with simple duodenal ulcer without chronic pancreatitis are mostly Helicobacter pylori-infected, and the prevalence of IgG seropositivity is > 95%. The prevalence of H. pylori infection in patients with chronic pancreatitis is not known. METHODS: IgG antibodies against H. pylori were measured in a cross-sectional survey of consecutive patients who had their exocrine pancreas function examined with a Lundh meal test in the period 1988-95 and in a control group of patients with simple duodenal ulcer. RESULTS: Twenty-seven per cent of the patients with chronic pancreatitis had duodenal ulcer during the observation period. The prevalence of IgG antibodies against H. pylori was 22% in patients with chronic pancreatitis without duodenal ulcer as compared with 27% with non-organic abdominal pain. The prevalence of IgG antibodies against H. pylori was 60% in patients with chronic pancreatitis complicated by duodenal ulcer as compared with 86% in controls with simple duodenal ulcer. CONCLUSIONS: H. pylori infection contributes but may not be the only cause of duodenal ulcer in patients with chronic pancreatitis.
Adult↗
An abundance of p53 null mutations in ovarian carcinoma.
Ovarian cancers from 64 midwestern US women were screened for p53 dysfunction both by immunohistochemical staining (IHCS) and single strand conformation polymorphism (SSCP) analysis of the entire open reading frame (ORF). Forty SSCP abnormalities in 39 tumors included nine deletion, one insertion, two splice junction, two nonsense, one silent and 25 missense mutations were confirmed by direct genomic sequencing. Eight of the insertion/deletion defects may have occurred due to slippage during the course of DNA replication. This observation suggests that genomic instability may play an important role in ovarian carcinogenesis. Fifteen percent of the mutations encountered were located outside exons 5-9 and four of these were null. The sensitivity of IHCS was 96% for missense mutations but only 14% for null mutations. This contrasted with 100% sensitivity of the SSCP screening methodology. The 21% overall incidence of null mutations in the present study far exceeds the reported 6.8% incidence in the world literature (P=0.0003). Explanations for this difference include: (1) our complete analysis of the entire ORF of the p53 gene; (2) the tendency of others to rely upon IHCS to screen tumors prior to mutation analysis; and (3) environmental or endogenous genetic influences.
Adult↗
p53 gene mutation analysis and antisense-mediated growth inhibition of human ovarian carcinoma cell lines.
Targeting dysfunctional gene expression in the cancer cell with gene-specific therapeutics requires knowledge of the structure and expression of the designated gene. Because of the prevalence of p53 dysfunction in epithelial ovarian carcinoma, modulation of the expression of this tumor suppressor gene is an attractive target for gene therapy. We sequenced the p53 gene and analyzed its expression in 10 ovarian cancer cell lines. Only five cell line mutations were encountered, three associated with a loss of heterozygosity. Thus, neither p53 mutation nor allelic loss is required for ovarian carcinogenesis or propagation of ovarian cancer cell lines in vitro. SSCP screening, but not immunohistochemical staining, correlated with results of direct genomic sequencing. All p53 immunohistochemical-negative cell lines differed from that reported by another laboratory, underscoring the importance of the knowledge of target gene expression in a given cell line in a given laboratory. We designed pilot studies of antisense oligodeoxynucleotides directed against the p53 gene based on our sequence data. Differential growth inhibition of the A2780-CP-20 cell line (mutant p53 protein), but not of the OVCAR-3 cell line (wild-type p53 protein) confirmed the potential usefulness of this strategy.
Base Sequence↗
Visual inspection of three-dimensional objects by human observers.
Eye movements are an important aid in active visual exploration of the environment and in performing behavioural tasks. Eye movements might also play a role in human perception of three-dimensional (3-D) objects. Eye-movement strategies were investigated when humans inspected and memorised 3-D objects. Subjects were instructed to memorise the 3-D structure of parts of statues of human figures placed on a turntable free to rotate through 360 degrees. Eye movements and turning behaviour were recorded. Different turning and eye-movement strategies could be observed. Subjects showed individual turning behaviours that were reproducible between trials. Turning strategies ranged from focusing on only a limited number of perspective views to almost continuously rotating the object with only short stops. On average twelve-thirteen views were inspected during memorising. Eye movements also revealed individual strategies. Fixation locations within each inspection view ranged from either closely spaced on isolated parts of the object to distributed over the whole view with large saccades in between. Eye movements were often directed to the same details from different perspectives. The differences in turning and viewing strategy also resulted in differences in the ability to recognise parts of the object later on. In general, successful later recognition required that the subject actually fixated the part to be recognised. A strategy of thoroughly inspecting the object with a series of closely spaced fixations from only a limited number of viewpoints led to best recognition rates. This was especially true for two subjects trained in fine arts with prior experiences in modelling. The results support models of viewpoint-dependent object recognition with viewer-centred, two-dimensional representations of 3-D objects.
Adult↗
Evaluation of a short-term computer-assisted training programme for the remediation of attentional deficits after brain injury: a preliminary study.
Explore the source record for details and available documents.
Adult↗
Isolation and preliminary characterization of an ovarian carcinoma cell line from a patient with familial ovarian cancer.
An epithelial ovarian cancer cell line is established from a patient with recurrent familial ovarian cancer. Two of the patient's sisters and her mother have also had ovarian cancer. The histological resemblance of the cell line to the patient's Stage IV, Grade 3 papillary serous ovarian primary cancer is striking. The cell line does not secrete CA125 and is estrogen and progesterone receptor negative. Overexpression of the p53 tumor suppressor gene but not the HER-2/neu oncogene was detected by immunohistochemical analysis. An unusual chemosensitivity to cisplatin, doxorubicin, etoposide, and taxol is demonstrated, suggesting that a chemosensitivity mechanism might explain prolonged survival of some patients with familial ovarian cancers. This truly unique cell line should prove invaluable in the further evaluation of molecular genetic changes associated with familial ovarian cancers.
Antineoplastic Agents↗