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Eefsen RL, Larsen JS, Klarskov LL, Altaf R, Høgdall E, Ingeholm P, Lykke J, Nielsen DL, Pfeiffer P, Poulsen LØ, Qvortrup C, Schou JV, Mau-Sørensen M, Østerlind K, Jensen BV. Therapy with pembrolizumab in treatment-naïve patients with nonmetastatic, mismatch repair deficient colorectal cancer. Int J Cancer 2023; 152:2145-2152. [PMID: 36594580 DOI: 10.1002/ijc.34420] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 12/16/2022] [Accepted: 12/20/2022] [Indexed: 01/04/2023]
Abstract
Therapy with immune checkpoint inhibitors (ICI) is effective in patients with metastatic mismatch-repair deficient (dMMR) colorectal cancer (CRC); however, data on treatment with neoadjuvant ICI in patients with locally advanced CRC are limited. From March 2019 to June 2020, five Danish oncological centers treated 10 patients with a treatment-naïve dMMR CRC with preoperative pembrolizumab, 9 with a nonmetastatic, unresectable colon cancer and 1 with a locally advanced rectum cancer. All 10 patients were evaluated regularly at a multidisciplinary team (MDT) meeting, and they all had a radical resection after a median of 8 cycles (range 2-13) of pembrolizumab. A microscopic evaluation of the resected tumors revealed no remaining tumor cells in five patients, while five still had tumor cells present. The patients were given no additional therapy. No recurrences were reported after a median follow-up of 26 months (range 23-38.5 months). Biopsies from Danish patients with CRC are routinely screened for dMMR proteins. In 2017, data from the Danish Colorectal Cancer Group showed that 19% (565/3000) of the patients with colon cancer and 1.5% (19/1279) of those with rectum cancer had an dMMR tumor. Among the patients with MMR determination, 26% (99/384) patients had a T4 dMMR colon cancer; thus, the 10 patients treated with neoadjuvant pembrolizumab comprised about 9% of the patients with a T4 dMMR colon cancer (9/99) and 5% of patients with dMMR rectal cancer (1/19). Therapy with pembrolizumab was feasible and effective. Larger prospective trials are needed to confirm our findings.
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Affiliation(s)
- Rikke Løvendahl Eefsen
- Department of Oncology, Copenhagen University Hospital-Herlev and Gentofte, Herlev, Denmark
| | - Jim S Larsen
- Department of Oncology, Copenhagen University Hospital-Herlev and Gentofte, Herlev, Denmark
| | - Louise L Klarskov
- Department of Pathology, Copenhagen University Hospital-Herlev and Gentofte, Herlev, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Rahim Altaf
- Department of Oncology, Zealand University Hospital, Roskilde, Denmark
| | - Estrid Høgdall
- Department of Pathology, Copenhagen University Hospital-Herlev and Gentofte, Herlev, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Peter Ingeholm
- Department of Pathology, Copenhagen University Hospital-Herlev and Gentofte, Herlev, Denmark
| | - Jakob Lykke
- Department of Surgery, Copenhagen University Hospital-Herlev and Gentofte, Herlev, Denmark
| | - Dorte L Nielsen
- Department of Oncology, Copenhagen University Hospital-Herlev and Gentofte, Herlev, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Per Pfeiffer
- Department of Oncology, Odense University Hospital, Odense, Denmark
| | - Laurids Ø Poulsen
- Department of Oncology, Aalborg University Hospital, Aalborg, Denmark
| | - Camilla Qvortrup
- Department of Oncology, Copenhagen University Hospital-Rigshospitalet, København, Denmark
| | - Jakob V Schou
- Department of Oncology, Copenhagen University Hospital-Herlev and Gentofte, Herlev, Denmark
| | - Morten Mau-Sørensen
- Department of Oncology, Copenhagen University Hospital-Rigshospitalet, København, Denmark
| | - Kell Østerlind
- Department of Oncology, Northern Zealand University Hospital, Hillerød, Denmark
| | - Benny V Jensen
- Department of Oncology, Copenhagen University Hospital-Herlev and Gentofte, Herlev, Denmark
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Dolin TG, Christensen IJ, Lund CM, Bojesen SE, Lykke J, Nielsen DL, Larsen JS, Johansen JS. Preoperative plasma vitamin D in patients with localized colorectal cancer: Age-dependent association with inflammation, postoperative complications, and survival. Eur J Surg Oncol 2023; 49:244-251. [PMID: 36137882 DOI: 10.1016/j.ejso.2022.08.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 08/22/2022] [Accepted: 08/31/2022] [Indexed: 01/24/2023] Open
Abstract
INTRODUCTION Aging is often associated with low-grade chronic inflammation and a senescent immune system. Vitamin D is a regulator of immune function, and low plasma vitamin D is associated with poor health. The association between plasma vitamin D and inflammatory biomarkers and risk of postoperative complications and survival in patients with colorectal cancer (CRC) is unknown. Our aim was to investigate these associations and how they are influenced by age. MATERIALS AND METHODS Circulating vitamin D and the inflammatory biomarkers C-reactive protein (CRP), interleukin (IL)-6, and YKL-40 were measured in 398 patients with stage I-III CRC preoperatively. Older patients (≥70 years, n = 208) were compared to younger patients (<70 years, n = 190). The relation between vitamin D and complications and high inflammatory biomarker levels was presented by odds ratios ([OR], 95% confidence interval [CI]). Associations with survival were presented with hazard ratios ([HR], 95% CI). RESULTS Plasma vitamin D was higher in older patients than in younger patients (75 vs. 67 nmol/L, P = 0.001). High vitamin D was associated with low plasma CRP in younger patients (OR = 0.35, 95% CI 0.17-0.76), but not in older patients (OR = 0.93, 0.49-1.76). High vitamin D in older patients with CRC was associated with reduced risk of major complications (OR = 0.52, 0.28-0.95). This was not found in younger patients (OR = 1.47, 0.70-3.11). Deficient vitamin D (<25 nmol/L) was associated with short overall survival compared to sufficient (>50 nmol/L) irrespective of age (HR = 3.39, 1.27-9.37, P = 0.02). CONCLUSION For patients with localized CRC, high vitamin D levels before resection were associated with reduced risk of high inflammatory biomarkers for younger patients and reduced risk of major postoperative complications for older patients. Vitamin D deficiency was associated with reduced survival regardless of age.
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Affiliation(s)
- Troels G Dolin
- Department of Medicine, Copenhagen University Hospital - Herlev and Gentofte, Borgmester Ib Juuls Vej 1, 2730, Herlev, Denmark.
| | - Ib J Christensen
- Department of Gastrointestinal Surgery, Copenhagen University Hospital - Hvidovre, Kettegård Alle 30, 2650, Hvidovre, Denmark
| | - Cecilia M Lund
- Department of Medicine, Copenhagen University Hospital - Herlev and Gentofte, Borgmester Ib Juuls Vej 1, 2730, Herlev, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Stig E Bojesen
- Department of Clinical Biochemistry, Copenhagen University Hospital - Herlev and Gentofte, Borgmester Ib Juuls Vej 1, 2730, Herlev, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Jakob Lykke
- Department of Gastrointestinal Surgery, Copenhagen University Hospital - Herlev and Gentofte, Borgmester Ib Juuls Vej 1, 2730, Herlev, Denmark
| | - Dorte L Nielsen
- Department of Oncology, Copenhagen University Hospital - Herlev and Gentofte, Borgmester Ib Juuls Vej 1, 2730, Herlev, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Jim S Larsen
- Department of Oncology, Copenhagen University Hospital - Herlev and Gentofte, Borgmester Ib Juuls Vej 1, 2730, Herlev, Denmark
| | - Julia S Johansen
- Department of Medicine, Copenhagen University Hospital - Herlev and Gentofte, Borgmester Ib Juuls Vej 1, 2730, Herlev, Denmark; Department of Oncology, Copenhagen University Hospital - Herlev and Gentofte, Borgmester Ib Juuls Vej 1, 2730, Herlev, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
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Andersen SE, Andersen IB, Jensen BV, Pfeiffer P, Ota T, Larsen JS. A systematic review of observational studies of trifluridine/tipiracil (TAS-102) for metastatic colorectal cancer. Acta Oncol 2019; 58:1149-1157. [PMID: 31002008 DOI: 10.1080/0284186x.2019.1605192] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Background: The treatment options for patients with therapy refractory metastatic colorectal cancer (mCRC) are sparse. TAS-102 (FTD/TPI) is a new oral anti-tumour agent composed of a nucleoside analogue, trifluridine, and a thymidine phosphorylase inhibitor, tipiracil, indicated for patients with mCRC who are refractory to standard therapies. This study summarizes published and unpublished experience with FTD/TPI in clinical practice settings. Patients and methods: The Medline/PubMed, Embase and Cochrane Library databases were searched to identify observational studies on FTD/TPI monotherapy for mCRC. Papers describing use of FTD/TPI monotherapy outside clinical trials in series of patients evaluable for effectiveness were eligible. The outcomes of interest were median progression free survival (mPFS), median overall survival (mOS) as well as mean PFS time restricted to six months (PFS6m) and mean OS time restricted to one year (OS1y). Results of the pooled analyses of observational studies were compared to the results of the Japanese phase II trial and the two phase III trials, RECOURSE and TERRA. Results: Seven published and two unpublished studies with 1008 patients from 64 centres were included for analysis. The pooled mPFS was 2.2 months (95% CI 2.1 to 2.3 months), and the pooled mOS was 6.6 months (95% CI 6.1 to 7.1 months). PFS6m was 2.9 months (95% CI 2.6 to 3.1 months) and OS1y was 6.8 (95% CI 6.0 to 7.5) months. While these results all reflect RECOURSE, the pooled mOS is lower than in the phase II trial and the OS1y is inferior to both the phase II trial and TERRA. Conclusion: This systematic review and a meta-analysis indicates that in real life settings, the survival benefit of FTD/TPI monotherapy in patients with therapy refractory mCRC reflects the outcomes in RECOURSE but is inferior to outcomes in the two Asian efficacy trials. What is already known TAS 102 (Lonsurf) is an oral fixed dose combination of trifluridine (FTD) and tipiracil (TPI) indicated as salvage-line treatment in patients with therapy refractory metastatic colorectal cancer (mCRC). A Japanese phase II trial and two phase III trials, RECOURSE and TERRA, demonstrated that FTD/TPI prolonged overall survival. What this study adds This systematic review and meta-analysis of real life data from 64 sites indicates that the effectiveness in daily clinical practice settings of FTD/TPI monotherapy in late stage mCRC reflects the outcomes in RECOURCE but is inferior to the outcomes in the Japanese phase II trial and TERRA.
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Affiliation(s)
- Stig E. Andersen
- Clinical Pharmacology Unit, Zealand University Hospital, Roskilde, Denmark
| | - Ida B. Andersen
- Clinical Pharmacology Unit, Zealand University Hospital, Roskilde, Denmark
| | - Benny V. Jensen
- Department of Oncology, Herlev University Hospital, Herlev, Denmark
| | - Per Pfeiffer
- Department of Oncology, Odense University Hospital, Odense, Denmark
| | - Takayo Ota
- Department of Medical Oncology, Izumi City General Hospital, Izumi, Osaka Japan
| | - Jim S. Larsen
- Department of Oncology, Zealand University Hospital, Roskilde, Denmark
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Boisen MK, Dehlendorff C, Linnemann D, Nielsen BS, Larsen JS, Østerlind K, Nielsen SE, Tarpgaard LS, Qvortrup C, Pfeiffer P, Holländer NH, Keldsen N, Hansen TF, Jensen BB, Høgdall EVS, Jensen BV, Johansen JS. Tissue microRNAs as predictors of outcome in patients with metastatic colorectal cancer treated with first line Capecitabine and Oxaliplatin with or without Bevacizumab. PLoS One 2014; 9:e109430. [PMID: 25329796 PMCID: PMC4198118 DOI: 10.1371/journal.pone.0109430] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Accepted: 08/22/2014] [Indexed: 01/01/2023] Open
Abstract
Purpose We tested the hypothesis that expression of microRNAs (miRNAs) in cancer tissue can predict effectiveness of bevacizumab added to capecitabine and oxaliplatin (CAPEOX) in patients with metastatic colorectal cancer (mCRC). Experimental Design Patients with mCRC treated with first line CAPEOX and bevacizumab (CAPEOXBEV): screening (n = 212) and validation (n = 121) cohorts, or CAPEOX alone: control cohort (n = 127), were identified retrospectively and archival primary tumor samples were collected. Expression of 754 miRNAs was analyzed in the screening cohort using polymerase chain reaction (PCR) arrays and expression levels were related to time to disease progression (TTP) and overall survival (OS). Significant miRNAs from the screening study were analyzed in all three cohorts using custom PCR arrays. In situ hybridization (ISH) was done for selected miRNAs. Results In the screening study, 26 miRNAs were significantly correlated with outcome in multivariate analyses. Twenty-two miRNAs were selected for further study. Higher miR-664-3p expression and lower miR-455-5p expression were predictive of improved outcome in the CAPEOXBEV cohorts and showed a significant interaction with bevacizumab effectiveness. The effects were strongest for OS. Both miRNAs showed high expression in stromal cells. Higher expression of miR-196b-5p and miR-592 predicted improved outcome regardless of bevacizumab treatment, with similar effect estimates in all three cohorts. Conclusions We have identified potentially predictive miRNAs for bevacizumab effectiveness and additional miRNAs that could be related to chemotherapy effectiveness or prognosis in patients with mCRC. Our findings need further validation in large cohorts, preferably from completed randomized trials.
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Affiliation(s)
- Mogens K. Boisen
- Department of Oncology, Herlev University Hospital, Herlev, Denmark
- * E-mail:
| | - Christian Dehlendorff
- Statistics, Bioinformatics and Registry, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Dorte Linnemann
- Department of Pathology, Herlev University Hospital, Herlev, Denmark
| | | | - Jim S. Larsen
- Department of Oncology, Roskilde Hospital, Roskilde, Denmark
| | - Kell Østerlind
- Department of Oncology, Rigshospitalet, Copenhagen, Denmark
| | - Svend E. Nielsen
- Department of Oncology and Palliation, Hillerød Hospital, Hillerød, Denmark
| | | | - Camilla Qvortrup
- Department of Oncology, Odense University Hospital, Odense, Denmark
| | - Per Pfeiffer
- Department of Oncology, Odense University Hospital, Odense, Denmark
| | | | - Nina Keldsen
- Department of Oncology, Herning Hospital, Herning, Denmark
| | | | - Brita B. Jensen
- Department of Medicine, Queen Ingrid Hospital, Nuuk, Greenland
- Department of Oncology, Sydvestjysk Hospital, Esbjerg, Denmark
| | | | - Benny V. Jensen
- Department of Oncology, Herlev University Hospital, Herlev, Denmark
| | - Julia S. Johansen
- Department of Oncology, Herlev University Hospital, Herlev, Denmark
- Department of Medicine, Herlev University Hospital, Herlev, Denmark
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Boisen MK, Johansen JS, Dehlendorff C, Larsen JS, Østerlind K, Hansen J, Nielsen SE, Pfeiffer P, Tarpgaard LS, Holländer NH, Keldsen N, Hansen TF, Jensen BB, Jensen BV. Primary tumor location and bevacizumab effectiveness in patients with metastatic colorectal cancer. Ann Oncol 2013; 24:2554-2559. [PMID: 23864097 DOI: 10.1093/annonc/mdt253] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND There is an unmet need for predictive markers for the antiangiogenic agent bevacizumab in metastatic colorectal cancer (mCRC). We aimed to assess whether the location of the primary tumor is associated with bevacizumab effectiveness when combined with capecitabine and oxaliplatin (CAPEOX) in the first-line treatment of patients with mCRC. PATIENTS AND METHODS A cohort of 667 consecutive patients with mCRC from the general community treated from 2006 to 2011 with CAPEOX and bevacizumab as standard first-line therapy was compared with a cohort of 213 patients treated with CAPEOX from 2003 to 2006, before bevacizumab was approved. Main outcome measures were progression-free survival (PFS) and overall survival (OS). Differences in outcome were tested using Kaplan-Meier curves and log-rank tests, and multivariate analyses were carried out using Cox Proportional Hazards models. RESULTS Patients treated with CAPEOX and bevacizumab with primary tumors originating in the sigmoid colon and rectum had a significantly better outcome than patients with primary tumors originating from the cecum to the descending colon, both for PFS (median PFS 9.3 versus 7.2 months; hazard ratio (HR) 0.68, 95% confidence interval (CI) 0.56-0.82) and for OS (median OS 23.5 versus 13.0 months; HR 0.47, 95% CI 0.38-0.57). This difference was confirmed in multivariate analyses after adjustment for other potentially prognostic factors. For patients treated with CAPEOX, there was no association between primary tumor location and outcome, neither in unadjusted nor adjusted analyses. CONCLUSIONS The addition of bevacizumab to CAPEOX in first-line treatment of patients with mCRC may primarily benefit patients with primary tumors originating in the rectum and sigmoid colon. This hypothesis needs to be validated in data from completed randomized trials. CLINICALTRIALSGOV IDENTIFICATION NUMBER NCT00212615.
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Affiliation(s)
| | - J S Johansen
- Department of Oncology;; Department of Medicine, Herlev Hospital, Copenhagen University Hospital, Herlev
| | - C Dehlendorff
- Department of Statistics, Bioinformatics and Registry, Danish Cancer Society, Copenhagen
| | - J S Larsen
- Department of Oncology, Roskilde Sygehus, Roskilde
| | - K Østerlind
- Department of Oncology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - J Hansen
- Department of Oncology, Västerås County Hospital, Västerås, Sweden;; Department of Oncology, Aalborg Sygehus, Aalborg
| | - S E Nielsen
- Department of Oncology and Palliation, Hillerød Hospital, Hillerød
| | - P Pfeiffer
- Department of Oncology, Odense University Hospital, Odense
| | - L S Tarpgaard
- Department of Oncology, Odense University Hospital, Odense
| | - N H Holländer
- Department of Oncology and Hematology, Næstved Sygehus, Næstved
| | - N Keldsen
- Department of Oncology, Herning Hospital, Herning
| | - T F Hansen
- Department of Oncology, Vejle Sygehus, Vejle
| | - B B Jensen
- Department of Oncology, Sydvestjysk Sygehus, Esbjerg, Denmark
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Boisen MK, Dehlendorff C, Linnemann D, Larsen JS, Oesterlind K, Hansen J, Nielsen SE, Pfeiffer P, Tarpgaard LS, Hollander NH, Keldsen N, Hansen T, Jensen BB, Hoegdall EVS, Jensen BV, Johansen JS. Primary tumor location and expression of mir-664 as a combined biomarker for bevacizumab effectiveness in metastatic colorectal cancer. J Clin Oncol 2013. [DOI: 10.1200/jco.2013.31.15_suppl.3572] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
3572 Background: We aimed to identify tissue microRNAs (miRs) that could predict outcome for patients with metastatic colorectal cancer (mCRC) treated with first line bevacizumab (BEV) and chemotherapy (CT) but not for patients treated with CT alone. Methods: Patients with mCRC treated with first line capecitabine and oxaliplatin (CT) with or without BEV at ten hospitals were identified and data was extracted retrospectively. Formalin-fixed paraffin-embedded tissue samples from primary tumors were collected and RNA was purified from 3 x 10 µm sections, without micro-dissection. miR expression was measured using Applied Biosystems TaqMan Custom LDA cards profiling 22 selected miRs in duplicate. The 22 miRs were selected from a previous discovery study profiling 754 miRs. miR expression was related to time to disease progression (TTP) and overall survival (OS) in multivariate analyses using Cox proportional hazards models with adjustment for age, prior adjuvant treatment, and no. of metastatic sites. We have previously found that patients with primary tumors originating in the sigmoid colon and rectum (S+R) experienced a better outcome than patients with other primary tumor locations (caecum to descending colon) when treated with BEV, so our analyses were stratified by primary tumor location. Results: miR expression was measured in samples from 399 patients: 155 samples from the original CT+BEV discovery study, 119 samples from a new CT+BEV cohort, and 125 samples from a CT alone cohort. Expression of miR-664 showed a significant positive association with increasing TTP, OS, and response rate (RR), but only in the cohort of patients with sigmoid colon- and rectal primary tumors treated with CT+BEV (n=183). Conclusions: We have identified a subgroup of patients with mCRC that are likely to benefit from BEV addition to first line CT using the combined information of location of the primary tumor and expression level of miR-664. [Table: see text]
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Affiliation(s)
- Mogens Karsboel Boisen
- Department of Oncology, Herlev Hospital, Copenhagen University Hospital, Copenhagen, Denmark
| | | | | | - Jim S. Larsen
- Department of Oncology, Roskilde Hospital, Roskilde, Denmark
| | | | - Joergen Hansen
- Department of Oncology, Västerås County Hospital and Department of Oncology, Aalborg Sygehus, Västerås, Sweden
| | | | - Per Pfeiffer
- Department of Oncology, Odense University Hospital, Odense, Denmark
| | | | | | - Nina Keldsen
- Department of Oncology, Regionshospital Herning, Herning, Denmark
| | - Torben Hansen
- Department of Oncology, Vejle Hospital, Vejle, Denmark
| | | | | | - Benny Vittrup Jensen
- Department of Oncology, Herlev Hospital, Copenhagen University Hospital, Herlev, Denmark
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Boisen MK, Dehlendorff C, Linnemann D, Ranc K, Jensen BV, Høgdall EV, Larsen JS, Nielsen SE, Andersen KK, Johansen JS. Discovery of microRNAs in tumor tissue predictive of time to progression and overall survival in patients with colorectal cancer treated with first-line capecitabine, oxaliplatin, and bevacizumab. J Clin Oncol 2012. [DOI: 10.1200/jco.2012.30.4_suppl.461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
461 Background: The aim was to identify predictive and prognostic microRNAs (miRNAs) in cancer tissue samples from patients with metastatic colorectal cancer (mCRC) treated with 1.-line capecitabine, oxaliplatin, and bevacizumab (CapOxBev). Methods: Patients with mCRC treated with 1.-line CapOxBev were identified from 7 hospital databases and clinical and pathological data was extracted retrospectively. Formalin-fixed paraffin-embedded (FFPE) tissue samples from primary tumors were collected and RNA was purified from 3 x 10 µm sections, without micro-dissection. MiRNA expression was measured using TaqMan® Array Human MicroRNA A and B cards (Applied Biosystems) profiling 754 miRNAs. Raw miRNA expression values were checked for outliers and data was corrected using spike-in values. In a univariate selection method, each miRNA was related to time-to-progression (TTP) and overall survival (OS) using Cox proportional hazards model (threshold p < 0.001). Candidate miRNAs were tested using Akaike’s Information Criterion in a multivariate analysis corrected for age, sex, histology, number of metastatic sites, primary location, and prior adjuvant treatment. Results: Samples from 212 patients were profiled and 205 and 192 had acceptable miRNA and outcome data available for final analysis of OS and TTP, respectively. Four miRNAs were found to be predictive for TTP and two for OS. Higher expression of miRNAs A, B, and C and lower expression of miRNA D was predictive of longer TTP, and higher expression of miRNAs E and F predicted longer OS. Conclusions: Four miRNAs measured in archival FFPE samples of primary CRC tumors from patients treated with 1.-line CapOxBev were predictors of TTP and two others of OS. Three of the miRNAs found have reported roles in angiogenesis pathways indicating that they may be biomarkers for bevacizumab efficacy. A validation study in 500 patients is on-going. [Table: see text]
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Affiliation(s)
- Mogens Karsboel Boisen
- Department of Oncology, Herlev Hospital, Herlev, Denmark; Department of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark; Department of Pathology, Herlev Hospital, Herlev, Denmark; Department of Oncology, Roskilde Hospital, Roskilde, Denmark; Department of Oncology and Palliative Care, Hilleroed Hospital, Hilleroed, Denmark
| | - Christian Dehlendorff
- Department of Oncology, Herlev Hospital, Herlev, Denmark; Department of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark; Department of Pathology, Herlev Hospital, Herlev, Denmark; Department of Oncology, Roskilde Hospital, Roskilde, Denmark; Department of Oncology and Palliative Care, Hilleroed Hospital, Hilleroed, Denmark
| | - Dorte Linnemann
- Department of Oncology, Herlev Hospital, Herlev, Denmark; Department of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark; Department of Pathology, Herlev Hospital, Herlev, Denmark; Department of Oncology, Roskilde Hospital, Roskilde, Denmark; Department of Oncology and Palliative Care, Hilleroed Hospital, Hilleroed, Denmark
| | - Kristina Ranc
- Department of Oncology, Herlev Hospital, Herlev, Denmark; Department of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark; Department of Pathology, Herlev Hospital, Herlev, Denmark; Department of Oncology, Roskilde Hospital, Roskilde, Denmark; Department of Oncology and Palliative Care, Hilleroed Hospital, Hilleroed, Denmark
| | - Benny V. Jensen
- Department of Oncology, Herlev Hospital, Herlev, Denmark; Department of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark; Department of Pathology, Herlev Hospital, Herlev, Denmark; Department of Oncology, Roskilde Hospital, Roskilde, Denmark; Department of Oncology and Palliative Care, Hilleroed Hospital, Hilleroed, Denmark
| | - Estrid V. Høgdall
- Department of Oncology, Herlev Hospital, Herlev, Denmark; Department of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark; Department of Pathology, Herlev Hospital, Herlev, Denmark; Department of Oncology, Roskilde Hospital, Roskilde, Denmark; Department of Oncology and Palliative Care, Hilleroed Hospital, Hilleroed, Denmark
| | - Jim S. Larsen
- Department of Oncology, Herlev Hospital, Herlev, Denmark; Department of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark; Department of Pathology, Herlev Hospital, Herlev, Denmark; Department of Oncology, Roskilde Hospital, Roskilde, Denmark; Department of Oncology and Palliative Care, Hilleroed Hospital, Hilleroed, Denmark
| | - Svend Erik Nielsen
- Department of Oncology, Herlev Hospital, Herlev, Denmark; Department of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark; Department of Pathology, Herlev Hospital, Herlev, Denmark; Department of Oncology, Roskilde Hospital, Roskilde, Denmark; Department of Oncology and Palliative Care, Hilleroed Hospital, Hilleroed, Denmark
| | - Klaus Kaae Andersen
- Department of Oncology, Herlev Hospital, Herlev, Denmark; Department of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark; Department of Pathology, Herlev Hospital, Herlev, Denmark; Department of Oncology, Roskilde Hospital, Roskilde, Denmark; Department of Oncology and Palliative Care, Hilleroed Hospital, Hilleroed, Denmark
| | - Julia S. Johansen
- Department of Oncology, Herlev Hospital, Herlev, Denmark; Department of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark; Department of Pathology, Herlev Hospital, Herlev, Denmark; Department of Oncology, Roskilde Hospital, Roskilde, Denmark; Department of Oncology and Palliative Care, Hilleroed Hospital, Hilleroed, Denmark
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Larsen JS. The sagittal growth of the eye. II. Ultrasonic measurement of the axial diameter of the lens and the anterior segment from birth to puberty. Acta Ophthalmol 2009; 49:427-40. [PMID: 5171608 DOI: 10.1111/j.1755-3768.1971.tb00968.x] [Citation(s) in RCA: 84] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Larsen JS. The sagittal growth of the eye. 3. Ultrasonic measurement of the posterior segment (axial length of the vitreous) from birth to puberty. Acta Ophthalmol 2009; 49:441-53. [PMID: 5171609 DOI: 10.1111/j.1755-3768.1971.tb00969.x] [Citation(s) in RCA: 79] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Larsen JS. Senile exfoliation (pseudo-exfoliation, fibrillopathia epitheliocapsularis) of the lens capsule in a postmortem material. Microscopic investigation of 100 eyes. Acta Ophthalmol 2009; 47:676-84. [PMID: 4899984 DOI: 10.1111/j.1755-3768.1969.tb08155.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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16
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Pedersen EB, Kornerup HJ, Larsen JS. The renin-aldosterone system during exercise in young patients with essential hypertension. Acta Med Scand Suppl 2009; 646:90-93. [PMID: 7018188 DOI: 10.1111/j.0954-6820.1981.tb02626.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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17
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Mirza NR, Larsen JS, Mathiasen C, Jacobsen TA, Munro G, Erichsen HK, Nielsen AN, Troelsen KB, Nielsen EØ, Ahring PK. NS11394 [3'-[5-(1-hydroxy-1-methyl-ethyl)-benzoimidazol-1-yl]-biphenyl-2-carbonitrile], a unique subtype-selective GABAA receptor positive allosteric modulator: in vitro actions, pharmacokinetic properties and in vivo anxiolytic efficacy. J Pharmacol Exp Ther 2008; 327:954-68. [PMID: 18791063 DOI: 10.1124/jpet.108.138859] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The novel positive allosteric modulator NS11394 [3'-[5-(1-hydroxy-1-methyl-ethyl)-benzoimidazol-1-yl]-biphenyl-2-carbonitrile] possesses a functional selectivity profile at GABA(A) receptors of alpha(5) > alpha(3) > alpha(2) > alpha(1) based on oocyte electrophysiology with human GABA(A) receptors. Compared with other subtype-selective ligands, NS11394 is unique in having superior efficacy at GABA(A)-alpha(3) receptors while maintaining low efficacy at GABA(A)-alpha(1) receptors. NS11394 has an excellent pharmacokinetic profile, which correlates with pharmacodynamic endpoints (CNS receptor occupancy), yielding a high level of confidence in deriving in vivo conclusions anchored to an in vitro selectivity profile and allowing for translation to higher species. Specifically, we show that NS11394 is potent and highly effective in rodent anxiety models. The anxiolytic efficacy of NS11394 is most probably mediated through its high efficacy at GABA(A)-alpha(3) receptors, although a contributory role of GABA(A)-alpha(2) receptors cannot be excluded. Compared with benzodiazepines, NS11394 has a significantly reduced side effect profile in rat (sedation, ataxia, and ethanol interaction) and mouse (sedation), even at full CNS receptor occupancy. We attribute this benign side effect profile to very low efficacy of NS11394 at GABA(A)-alpha(1) receptors and an overall partial agonist profile across receptor subtypes. However, NS11394 impairs memory in both rats and mice, which is possibly attributable to its efficacy at GABA(A)-alpha(5) receptors, albeit activity at this receptor might be relevant to its antinociceptive effects (J Pharmacol Exp Ther 327:doi;10.1124/jpet.108.144, 2008). In conclusion, NS11394 has a unique subtype-selective GABA(A) receptor profile and represents an excellent pharmacological tool to further our understanding on the relative contributions of GABA(A) receptor subtypes in various therapeutic areas.
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Affiliation(s)
- N R Mirza
- Department of Pharmacology, NeuroSearch A/S, Ballerup, Denmark.
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Munro G, Lopez-Garcia JA, Rivera-Arconada I, Erichsen HK, Nielsen EØ, Larsen JS, Ahring PK, Mirza NR. Comparison of the novel subtype-selective GABAA receptor-positive allosteric modulator NS11394 [3'-[5-(1-hydroxy-1-methyl-ethyl)-benzoimidazol-1-yl]-biphenyl-2-carbonitrile] with diazepam, zolpidem, bretazenil, and gaboxadol in rat models of inflammatory and neuropathic pain. J Pharmacol Exp Ther 2008; 327:969-81. [PMID: 18791060 DOI: 10.1124/jpet.108.144568] [Citation(s) in RCA: 90] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Spinal administration of GABA(A) receptor modulators, such as the benzodiazepine drug diazepam, partially alleviates neuropathic hypersensitivity that manifests as spontaneous pain, allodynia, and hyperalgesia. However, benzodiazepines are hindered by sedative impairments and other side effect issues occurring mainly as a consequence of binding to GABA(A) receptors containing the alpha(1) subunit. Here, we report on the novel subtype-selective GABA(A) receptor-positive modulator NS11394 [3'-[5-(1-hydroxy-1-methyl-ethyl)-benzoimidazol-1-yl]-biphenyl-2-carbonitrile], which possesses a functional efficacy selectivity profile of alpha(5) > alpha(3) > alpha(2) > alpha(1) at GABA(A) alpha subunit-containing receptors. Oral administration of NS11394 (1-30 mg/kg) to rats attenuated spontaneous nociceptive behaviors in response to hindpaw injection of formalin and capsaicin, effects that were blocked by the benzodiazepine site antagonist flumazenil. Ongoing inflammatory nociception, observed as hindpaw weight-bearing deficits after Freund's adjuvant injection, was also completely reversed by NS11394. Likewise, hindpaw mechanical allodynia was fully reversed by NS11394 in two rat models of peripheral neuropathic pain. Importantly, NS11394-mediated antinociception occurred at doses 20 to 40-fold lower than those inducing minor sedative or ataxic impairments. In contrast, putative antinociception associated with administration of either diazepam, zolpidem, or gaboxadol only occurred at doses producing intolerable side effects, whereas bretazenil was completely inactive despite minor influences on motoric function. In electrophysiological studies, NS11394 selectively attenuated spinal nociceptive reflexes and C-fiber-mediated wind-up in vitro pointing to involvement of a spinal site of action. The robust therapeutic window seen with NS11394 in animals suggests that compounds with this in vitro selectivity profile could have potential benefit in clinical treatment of pain in humans.
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Affiliation(s)
- G Munro
- NeuroSearch A/S, Ballerup, Denmark
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Abstract
The coexistence of allergic rhinitis with asthma is widely recognized by clinicians. Histamine, a common mediator for both diseases, has a substantial role in the pathophysiology of asthma through its ability to produce smooth muscle contraction and promote vascular permeability. Because antihistamines often are administered to manage allergic rhinitis symptoms, the effects of antihistamines in asthma should be evaluated. The usefulness of first-generation antihistamines is limited by their side-effect profile, namely sedation and cognitive impairment. Second-generation antihistamines have only a modest effect in attenuating bronchospasm induced by histamine, cold air, exercise, and allergen bronchoprovocation, suggesting that second-generation antihistamines do not have a direct role as a single agent for treating asthma. Studies have shown that controlling allergic rhinitis with antihistamines has a small, indirect effect in improving asthma symptoms. Future work should be directed at improving the potency of antihistamines and defining their antiinflammatory activity.
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Affiliation(s)
- J S Larsen
- Clinical Research Institute, College of Pharmacy, University of Minnesota, Minneapolis 55402, USA
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Bundgaard H, Schmidt TA, Larsen JS, Kjeldsen K. K+ supplementation increases muscle [Na+-K+-ATPase] and improves extrarenal K+ homeostasis in rats. J Appl Physiol (1985) 1997; 82:1136-44. [PMID: 9104850 DOI: 10.1152/jappl.1997.82.4.1136] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Effects of K+ supplementation (approximately 200 mmol KCl/100 g chow) on plasma K+, K+ content, and Na+-K+-adeonsinetriphosphatase (ATPase) concentration ([Na+-K+-ATPase]) in skeletal muscles as well as on extrarenal K+ clearance were evaluated in rats. After 2 days of K+ supplementation, hyperkalemia prevailed (K+-supplemented vs. weight-matched control animals) [5.1 +/- 0.2 (SE) vs. 3.2 +/- 0.1 mmol/l, P < 0.05, n = 5-6], and after 4 days a significant increase in K+ content was observed in gastrocnemius muscle (104 +/- 2 vs. 97 +/- 1 micromol/g wet wt, P < 0.05, n = 5-6). After 7 days of K+ supplementation, a significant increase in [3H] ouabain binding site concentration (344 +/- 5 vs. 239 +/- 8 pmol/g wet wt, P < 0.05, n = 4) was observed in gastrocnemius muscle. After 2 wk, increases in plasma K+, K+ content, and [3H]ouabain binding site concentration in gastrocnemius muscle amounted to 40, 8, and 68% (P < 0.05) above values observed in weight-matched control animals, respectively. The latter change was confirmed by K+-dependent p-nitrophenyl phosphatase activity measurements. Fasting for 1 day reduced plasma K+ and K+ content in gastrocnemius muscle in rats that had been K+ supplemented for 2 wk by 3.1 +/- 0.3 mmol/l (P < 0.05, n = 5) and 15 +/- 2 micromol/g wet wt (P < 0.05, n = 5), respectively. After induction of anesthesia, arterial plasma K+ was measured during intravenous KCl infusion (0.75 mmol KCl x 100 g body wt(-1) x h(-1)). The K+-supplemented fasted group demonstrated a 42% (P < 0.05) lower plasma K+ rise, associated with a significantly higher increase in K+ content in gastrocnemius muscle of 7 micromol/g wet wt (P < 0.05, n = 5) compared with their control animals. In conclusion, K+ supplementation increases plasma K+, K+ content, and [Na+-K+-ATPase] in skeletal muscles and improves extrarenal K+ clearance capacity.
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Affiliation(s)
- H Bundgaard
- Department of Medicine B, The Heart Centre, Rigshospitalet, National University Hospital, Copenhagen, Denmark
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Larsen JS, Schmidt TA, Bundgaard H, Kjeldsen K. Reduced concentration of myocardial Na+,K(+)-ATPase in human aortic valve disease as well as of Na+,K(+)- and Ca(2+)-ATPase in rodents with hypertrophy. Mol Cell Biochem 1997; 169:85-93. [PMID: 9089635 DOI: 10.1023/a:1006851411650] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Myocardial Na+,K(+)-ATPase was studied in patients with aortic valve disease, and myocardial Na+,K(+)- and Ca(2+)-ATPase were assessed in spontaneously hypertensive rats (SHR) and hereditary cardiomyopathic hamsters using methods ensuring high enzyme recovery. Na+,K(+)-ATPase was quantified by [3H]ouabain binding to intact myocardial biopsies from patients with aortic valve disease. Aortic stenosis, regurgitation and a combination hereof were compared with normal human heart and were associated with reductions of left ventricular [3H]ouabain binding site concentration (pmol/g wet weight) of 56, 46 and 60%, respectively (p < 0.01). Na+,K(+)- and Ca(2+)-ATPases were quantified by K(+)- and Ca(2+)-dependent p-nitrophenyl phosphatase (pNPPase) activity determinations in crude myocardial homogenates from SHR and hereditary cardiomyopathic hamsters. When SHR were compared to age-matched Wistar Kyoto (WKY) rats an increase in heart-body weight ratio of 75% (p < 0.001) was associated with reductions of K(+)- and Ca(2+)-dependent pNPPase activities (mumol/min/g wet weight) of 42 (p < 0.01) and 27% (p < 0.05), respectively. When hereditary cardiomyopathic hamsters were compared to age-matched Syrian hamsters an increase in heart-body weight ratio of 69% (p < 0.001) was found to be associated with reductions in K(+)- and Ca(2+)-dependent pNPPase activities of 50 (p < 0.001) and 26% (p = 0.05), respectively. The reductions in Na+,K(+)- and Ca(2+)-ATPases were selective in relation to overall protein content and were not merely the outcome of increased myocardial mass relative to Na+,K(+)- and Ca(2+)-pumps. In conclusion, myocardial hypertrophy is in patients associated with reduced Na+,K(+)-ATPase concentration and in rodents with reduced Na+,K(+)- and Ca(2+)-ATPase concentrations. This may be of importance for development of heart failure and arrhythmia in hypertrophic heart disease.
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Affiliation(s)
- J S Larsen
- Department of Medicine B, Heart Centre, Rigshospitalet, National University Hospital, Copenhagen, Denmark
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Abstract
The role of leukotrienes (LTs) in asthma is reviewed, and research to develop anti-LT agents for this condition is described. Greater understanding of the role played by inflammatory cells and their mediators in the pathophysiology of asthma has shifted the emphasis of research from the bronchoconstriction component of the disease to the inflammatory one. LTs are believed to play a key role in the complex interplay of inflammatory cells that occurs in asthma. Inhibiting the production of LTs or blocking their receptor sites may decrease the inflammatory response and thereby provide a useful therapeutic modality. Three approaches have been used in attempts to affect the activity of LTs: inhibition of 5-lipoxygenase, inhibition of 5-lipoxygenase-activating protein, and LTD4-receptor antagonism. Investigational agents that have undergone clinical trials include zileuton (a 5-lipoxygenase inhibitor), MK-591 (a 5-lipoxygenase-activating protein inhibitor), and zafirlukast, pranlukast, and verlukast (three LT-receptor antagonists). Many studies suggest that these orally administered agents are effective, particularly with respect to the early asthmatic response to allergens and other challenges, and have a low adverse-effect profile; the reaction of greatest concern is elevation of liver enzymes, especially with zileuton. Larger trials conducted over longer periods, as well as comparative trials, will be necessary to delineate the ultimate role of these agents in asthma therapy. Because of the complexity of the inflammatory process in asthma, anti-LT agents are likely to become part of multidrug regimens. Using drugs to interfere with leukotrienes may prove beneficial in the treatment of asthma.
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Affiliation(s)
- J S Larsen
- College of Pharmacy, University of Minnesota, Minneapolis, USA
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Larsen JS, Møller BR, Ahrons S. [Endometrial resection. Peroperative complications and postoperative course]. Ugeskr Laeger 1996; 158:6444-7. [PMID: 8992680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The effectiveness of transcervical resection of the uterine endometrium was assessed in 106 consecutive women admitted for surgical treatment for menstrual disorders, suitable for treatment with endometrial resection. No hormonal pretreatment was given. Amenorrhoea occurred in about 25%; 80% were satisfied after the initial treatment and 86% were satisfied if the procedure was repeated after at least one year postoperatively. The results were the same in 34 (32%) who had fibroids or polyps in the uterine cavity. No serious operative or postoperative complications appeared. Seven patients (6.6%) required temporary tamponade to control bleeding. It is concluded that endometrial resection is an advance in the management of menstrual disorders. The satisfaction in the patients is high and the complication rate low.
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Affiliation(s)
- J S Larsen
- Gynaekologisk/obstetrisk afdeling D, Odense Universitetshospital
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Schmidt TA, Hasselbalch S, Larsen JS, Bundgaard H, Juhler M, Kjeldsen K. Reduction of cerebral cortical [3H]ouabain binding site (Na+,K(+)-ATPase) density in dementia as evaluated in fresh human cerebral cortical biopsies. Brain Res Cogn Brain Res 1996; 4:281-7. [PMID: 8957569 DOI: 10.1016/s0926-6410(96)00064-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Na+,K(+)-ATPase density in human cerebral cortex was for the first time studied by vanadate facilitated [3H]ouabain binding to intact samples. Fresh human cerebral cortical biopsies were obtained as a result of diagnostic frontal lobe biopsy from patients with normal pressure hydrocephalus (NPH) syndrome and associated dementia. For control measurements post-mortem samples were obtained from patients without clinically observed dementia. [3H]ouabain binding kinetics were evaluated: when incubating samples in 1 microM [3H]ouabain binding equilibrium was obtained after 6 h of incubation, non-specific uptake and retention amounted to only 2.3% of total uptake and retention of [3H]ouabain and release of specifically bound [3H]ouabain during washout in the cold occurred only slowly (T1/2 = 37 h). Evaluation of receptor affinity for ouabain was in agreement with a heterogeneous population of [3H]ouabain binding sites. [3H]Ouabain binding was significantly reduced after frozen storage of samples before measurements. Post-mortem degradation of cerebral [3H]ouabain binding sites occurred only slowly (T1/2 = 75 h). No significant variation in [3H]ouabain binding site density was observed between the cerebral lobes with occipital, parietal and temporal values (means +/- S.E.M., n = 5) amounting to 10281 +/- 649, 11267 +/- 1011 and 9263 +/- 615 pmol/g wet wt., respectively. [3H]Ouabain binding measured in frontal cortical samples gave values of (means +/- S.E.M., n = 5) 4274 +/- 1020 and 11397 +/- 976 pmol/g wet wt. delta % = 62; P < 0.05) in patients with dementia and controls, respectively. Human cerebral cortical capacity for active K+ uptake was around 37- and 16-fold greater than in skeletal muscular and myocardial tissue, respectively.
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Affiliation(s)
- T A Schmidt
- Department of Medicine B 2142, Rigshospitalet, National University Hospital, Copenhagen, Denmark
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Marshik PL, Larsen JS, Leach CL, Halverson PC, Ekholm BP, Amies MH, Kaiser HB, Weisberg SC, Sellers JA. A novel breath actuated device (Autohaler) consistently actuates during the early phase of inspiration. J Aerosol Med 1996; 8:187-95. [PMID: 10155353 DOI: 10.1089/jam.1995.8.187] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To establish and quantify the point during inspiration that the Autohaler (AH) inhalation system releases a metered dose of aerosol (placebo). The second objective was to determine if the Autohaler system actuates consistently, regardless of the canister life. DESIGN Double-blind, randomized, two-period crossover, one-day trial. SETTING Community based allergy and asthma clinic. PARTICIPANTS Twelve patients with mild to moderate asthma. RESULTS Mean verbal training time for the AH which included the patient demonstrating their ability to correctly use the AH was approximately 6 minutes. The mean time for actuation for the AH early in its canister life ("new canister") was 195 msec compared to 205 msec for the AH late in its canister life ("old canister") (p = 0.589). This represented the early part of inspiration as patients had a mean inspiratory duration of 2231 msec for the "new" AH and 2343 msec for the "old" AH. The mean percentage of inspiration time required to actuate the "new" AH was 8.92% compared to 8.82% for the "old" AH. Patients rated the system as easier to much easier to use compared with their current standard press and breathe inhaler. CONCLUSIONS The AH consistently actuates early during inspiration, which is considered the optimal time for drug delivery, regardless of the canister life.
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Affiliation(s)
- P L Marshik
- College of Pharmacy University of Minnesota, Minneapolis, MN, USA
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Larsen JS, Kjeldsen K. Quantification in crude homogenates of rat myocardial Na+, K(+)- and Ca(2+)-ATPase by K+ and Ca(2+)-dependent pNPPase. Age-dependent changes. Basic Res Cardiol 1995; 90:323-31. [PMID: 8534257 DOI: 10.1007/bf00797910] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Assays for complete quantification of Na+, K(+)- and Ca(2+)-ATPase in crude homogenates of rat ventricular myocardium by determination of K(+)- and Ca(2+)-dependent p-nitrophenyl phosphatase (pNPPase) activities were evaluated and optimized. Using these assays the total K(+)- and Ca(2+)-dependent pNPPase activities in ventricular myocardium of 11-12 week-old rats were found to be 2.98 +/- 0.10 and 0.29 +/- 0.02 mumol x min-1 x g-1 wet wt. (mean +/- SEM) (n = 5), respectively. Coefficient of variance of interindividual determinations was 7 and 12%, respectively. The total Na+, K(+)- and Ca(2+)-ATPase concentrations were estimated to 2 and 10 nmol x g-1 wet wt., respectively. Evaluation of a putative developmental variation revealed a biphasic age-related change in the rat myocardial Ca(2+)-dependent pNPPase activity with an increase from birth to around the third week of life followed by a decrease. By contrast, the K(+)-dependent pNPPase activity of the rat myocardium showed a decrease from birth to adulthood. It was excluded that the changes were simple outcome of variations in water and protein content of myocardium. Expressed per heart, the K(+)- and Ca(2+)-dependent pNPPase activity gradually increased to a plateau. The present assay for Na+, K(+)-ATPase quantification has the advantage over [3H] ouabain binding of being applicable on the ouabain-resistant rat myocardium, and is more simple and rapid than measurements of K(+)-dependent 3-O-methylfluorescein phosphatase (3-O-MFPase) in crude tissue homogenates. Furthermore, with few modifications the pNPPase assay allows quantification of Ca(2+)-ATPase on crude myocardial homogenates.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- J S Larsen
- Department of Medicine B2142, Rigshospitalet University of Copenhagen School of Medicine, Denmark
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Sams T, Ellegaard C, Gaarde C, Larsen JS, Boyard JL, Hennino T, Jourdain JC, Ramstein B, Roy-Stephan M, Radvanyi P, Brockstedt A, Österlund M, Zupranski P, Goodman CD, Ichimura M, Dmitriev VF. Quasifree (d. Phys Rev C Nucl Phys 1995; 51:1945-1960. [PMID: 9970263 DOI: 10.1103/physrevc.51.1945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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Abstract
Conventional press-and-breathe metered dose inhalers (MDIs) are widely prescribed but are often difficult for many patients to properly use. A total of 501 patients from different medical specialties were enrolled in this study, which evaluated how the patients used their MDIs. Using a conservative method (minimum number of errors) of determining errors, we found that 388 (77.5%) of the patients made at least one error when demonstrating how they use their MDI for two observers. Using a liberal (maximum number of errors) method of analysis, we found that 447 (89.2%) of the patients made at least one error. There was no difference in errors made stratified by patient gender, patient age, or the medical specialty that treated the patient's pulmonary disease. The two most common errors made by patients were failure to breathe out to functional residual capacity before actuation (225 by minimum method, 280 by maximum method) and not actuating the canister at the start of inhalation (207 by minimum method, 323 by maximum method). Of the patients with improper timing of actuation, the majority (121 patients by minimum method and 187 patients by maximum method) actuated the canister early. In this large patient sample, regardless of which medical specialty provided the treatment, the majority of the patients evaluated had less than optimal MDI technique. Routine assessment of MDI technique should be instituted as standard practice care.
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Affiliation(s)
- J S Larsen
- Allergy and Asthma Specialists, P.A., Minneapolis, MN 55402
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Johansen A, Dimon P, Ellegaard C, Larsen JS, Rugh HH. Dynamic phases in a spring-block system. Phys Rev E Stat Phys Plasmas Fluids Relat Interdiscip Topics 1993; 48:4779-4790. [PMID: 9961161 DOI: 10.1103/physreve.48.4779] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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Schmidt TA, Larsen JS, Shannon RP, Komamura K, Vatner DE, Kjeldsen K. Reduced 3H-ouabain binding site (Na,K-ATPase) concentration in ventricular myocardium of dogs with tachycardia induced heart failure. Basic Res Cardiol 1993; 88:607-20. [PMID: 8147825 DOI: 10.1007/bf00788878] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The present study evaluates 3H-ouabain binding site (Na,K-ATPase) concentration in left ventricular myocardium of dogs with heart failure induced by tachycardia as a result of ventricular pacing. Samples of left ventricle were obtained from 10 dogs exposed to pacing of 240 beats/min for 3 to 4 weeks and eight sham-operated controls. Na,K-ATPase was quantified using vanadate facilitated 3H-ouabain binding to intact samples. At time of sacrifice paced dogs showed clinical signs of heart failure, a significant 257% increase in left ventricular end diastolic pressure and a significant 46% decrease in left ventricular dP/dt compared with control. There was no significant change in left ventricular mass. 3H-ouabain binding concentration was significantly reduced by 16%. Evaluation of 3H-ouabain binding kinetics revealed no significant difference between myocardium from paced and control dogs: Equilibrium binding conditions were at the various concentrations used obtained after similar incubation time; nonspecific uptake and retention of 3H-ouabain was 0.9-0.8% of total uptake and retention obtained in the standard assay; apparent dissociation constant (KD) was 6.5 x 10(-8)-6.6 x 10(-8) mol/l; loss of specifically bound 3H-ouabain during washout at 0 degrees C occurred with a half-life time (T1/2) of 120 and 121 h. Hence, total 3H-ouabain binding site concentration in left ventricular myocardium was (mean +/- SEM) 1110 +/- 56 and 1317 +/- 68 pmol/g wet weight, 8.54 +/- 0.43 and 10.05 +/- 0.52 pmol/mg protein, and the total amount of 3H-ouabain binding sites in the entire left ventricle 121 +/- 6 and 162 +/- 8 nmol in paced (n = 10) and control (n = 8) dogs (p < 0.05), respectively. In conclusion, the present study reports a significant reduction in left ventricular myocardium 3H-ouabain binding site concentration in tachycardia induced heart failure. This observation supports the concept of a relationship between Na,K-ATPase concentration and contractile capacity and may be of pathophysiological importance in tachycardia and heart failure.
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Affiliation(s)
- T A Schmidt
- Department of Cardiothoracic Surgery RT, Rigshospitalet, University of Copenhagen, Denmark
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Larsen JS, Hahn M, Kochevar JW, Morris RJ, Kaiser HB, Weisberg SC, Halverson PC, Quessy SN. Administration errors with a conventional metered dose inhaler versus a novel breath actuated device. Ann Allergy 1993; 71:103-6. [PMID: 8346860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Metered dose inhalers are difficult for patients to use. A device that eliminates coordination and timing of actuation may simplify the use of metered dose inhalers. This trial compared (1) number of errors made and (2) specific errors made between the conventional press and breathe metered dose inhaler (MDI) and the novel breath actuated Autohaler inhalation device in 24 subjects. We studied the use of each device in 12 patients trained and experienced in using an MDI and in 12 volunteers who had never been exposed to any inhalation device. We observed that even experienced patients continue to have difficulty with the coordination and timing of metered dose inhalers. The volunteer group had equal difficulty with both devices but it appeared that it was easier for them to learn how to use the breath actuated device than the MDI.
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Affiliation(s)
- J S Larsen
- College of Pharmacy, University of Minnesota, Minneapolis
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32
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Abstract
OBJECTIVE To familiarize readers with a potentially new class of compounds for treating asthma. Background information on leukotrienes is provided in addition to an in-depth review of pertinent clinical trials. DATA SOURCES Information was obtained from controlled clinical trials, abstracts, and review articles identified through a MEDLINE search of English-language articles. STUDY SELECTION Emphasis was placed on early clinical trials that showed some benefit with these compounds as well as more recent studies using newer agents that produced more promising results. DATA EXTRACTION Information regarding leukotriene biochemistry was extracted from basic science research and data from human studies were evaluated by the authors according to patient selection, study design, methodology, and therapeutic response. DATA SYNTHESIS Leukotrienes have a pathophysiologic role in asthma. Two distinct but pharmacologically similar classes of leukotriene inhibitors are currently being clinically evaluated. These are leukotriene receptor antagonists and 5-lipoxygenase inhibitors. Early clinical trials with these agents yielded unfavorable results primarily because of lack of drug potency and selectivity, poor patient tolerance, and possibly the route of administration. Subsequent studies with more potent and selective agents have further implicated leukotrienes as biochemical mediators in asthma and, consequently, have shown promising clinical outcomes with respect to pulmonary function testing and patient tolerance. CONCLUSIONS Advancements in the pathogenesis of asthma are beginning to define a role for the leukotrienes. Although more studies are needed to assess the efficacy of leukotriene inhibitors, recent clinical trials using leukotriene-receptor antagonists and 5-lipoxygenase inhibitors indicate a potential for the expansion of therapeutic regimens currently used in the treatment of asthma.
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Affiliation(s)
- J S Larsen
- College of Pharmacy, University of Minnesota, Minneapolis
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Abstract
Na+,K(+)-ATPase concentration in rat cerebral cortex was studied by vanadate-facilitated [3H]ouabain binding to intact samples and by K(+)-dependent 3-O-methylfluorescein phosphatase activity determinations in crude homogenates. Methodological errors of both methods were evaluated. [3H]Ouabain binding to cerebral cortex obtained from 12-week-old rats measured incubating samples in buffer containing [3H]ouabain, and ouabain at a final concentration of 1 x 10(-6) mol/L gave a value of 11,351 +/- 177 (n = 5) pmol/g wet weight (mean +/- SEM) without any significant variation between the lobes. Evaluation of affinity for ouabain was in agreement with a heterogeneous population of [3H]ouabain binding sites. K(+)-dependent 3-O-methylfluorescein phosphatase activity in crude cerebral homogenates of age-matched rats was 7.24 +/- 0.14 (n = 5) mumol/min/g wet weight, corresponding to a Na+,K(+)-ATPase concentration of 12,209 +/- 236 pmol/g wet weight. It was concluded that the present methods were suitable for quantitative studies of cerebral cortex Na+,K(+)-ATPase. The concentration of rat cerebral cortex Na+,K(+)-ATPase showed approximately 10-fold increase within the first 4 weeks of life to reach a plateau of approximately 11,000-12,000 pmol/g wet weight, indicating a larger synthesis of Na+,K+ pumps than tissue mass in rat cerebral cortex during the first 4 weeks of development. K+ depletion induced by K(+)-deficient fodder for 2 weeks resulted in a slight tendency toward a reduction in K+ content (6%, p > 0.5) and Na+,K(+)-ATPase concentration (3%, p > 0.4) in cerebral cortex, whereas soleus muscle K+ content and Na+,K(+)-ATPase concentration were decreased by 30 (p < 0.02) and 32% (p < 0.001), respectively. Hence, during K+ depletion, cerebral cortex can maintain almost normal K+ homeostasis, whereas K+ as well as Na+,K+ pumps are lost from skeletal muscles.
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Affiliation(s)
- T A Schmidt
- Department of Medicine B 2142, Rigshospitalet, Copenhagen University School of Medicine, Denmark
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Larsen JS, Kjeldsen K. Ca2+-ATPase and Na+,K+-ATPase concentration with cardiac hypertrophy. J Mol Cell Cardiol 1992. [DOI: 10.1016/0022-2828(92)91553-h] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Larsen JS, Pedersen OD, Ipsen L. [Induction of labor when a large fetus is suspected]. Ugeskr Laeger 1991; 153:181-3. [PMID: 1998237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The courses of 945 deliveries in which the infant weighed greater than or equal to 3,800 g are reviewed retrospectively with comparison between the deliveries which began spontaneously and the induced deliveries. In the deliveries which were induced on account of a suspected large foetus, the frequency of emergency Cesarean section was tripled and the frequency of vacuum extraction was doubled. Significantly more infants had Apgar scores of less than 7 after one minute than in the deliveries which began spontaneously. It is concluded that induction of labour is not indicated in cases where a large foetus is suspected.
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Affiliation(s)
- J S Larsen
- Gynaekologisk/obstetrisk afdeling D. Svendborg Sygehus
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Quessy SN, Morris RJ, Larsen JS, Kaiser HB, Weisberg SC, Halverson PC. Sensitivity of FEV1 response following one and two inhalations of albuterol: a pilot study. J Asthma 1991; 28:323-8. [PMID: 1938767 DOI: 10.3109/02770909109089459] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Eleven patients entered a pilot study designed to evaluate the proportion of eligible responders following a single inhalation of albuterol aerosol, the degree of response, and the sensitivity to distinguish between one and two inhalations based on FEV1 response. Each patient received a single inhalation at 0 and 60 minutes. FEV1 was measured 30 and 60 minutes after each inhalation. Most patients (82%) responded to a single inhalation and the majority (73%) were capable of further response after two inhalations. This study design was able to distinguish FEV1 responses to one and two inhalations of albuterol and provide upward and downward sensitivity sufficient to detect major differences in products.
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Affiliation(s)
- S N Quessy
- 3M Pharmaceuticals, 3M Center, St. Paul, Minnesota 55144
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Siana JE, Rex S, Larsen JS. [Male sterilization. Historic review and current methods in Denmark]. Ugeskr Laeger 1988; 150:2157-9. [PMID: 3061100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Ellegaard C, Gaarde C, Jorgensen TS, Larsen JS, Goodman C, Bergqvist I, Brockstedt A, Ekström P, Bedjidian M, Contardo D, Grossiord JY, Guichard A, Bachelier D, Boyard JL, Hennino T, Jourdain JC, Roy-Stephan M, Radvanyi P, Tinsley J. Reaction (dpol,2He) at intermediate energies. Phys Rev Lett 1987; 59:974-977. [PMID: 10035926 DOI: 10.1103/physrevlett.59.974] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
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Kjeldsen K, Braendgaard H, Sidenius P, Larsen JS, Nørgaard A. Diabetes decreases Na+-K+ pump concentration in skeletal muscles, heart ventricular muscle, and peripheral nerves of rat. Diabetes 1987; 36:842-8. [PMID: 3034710 DOI: 10.2337/diab.36.7.842] [Citation(s) in RCA: 70] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Na+-K+-ATPase or the Na+-K+ pump is essential for some specific properties of muscle and nerve tissue such as contractility and excitability. Previous studies have shown conflicting variations in Na+-K+-ATPase activity or Na+-K+ pump concentration of muscle cells in experimental diabetes. Our study demonstrates that early untreated diabetes in rats induced by injection of streptozocin is associated with decreases in [3H]ouabain binding-site concentration of 24-48% in various skeletal muscles and 16% in peripheral nerves as well as a decrease in K+-dependent 3-O-methylfluorescein phosphatase activity of 21% in the heart ventricle. These effects could be prevented by insulin treatment. They probably represent a decrease in the concentration of Na+-K+ pumps. There was no evidence for more than one population of Na+-K+ pumps in intact samples of skeletal muscle and nerves from normal, diabetic, and insulin-treated animals. The decrease in Na+-K+ pump concentration in nerve cells may be due to atrophy of the axons. In skeletal muscles, myocardium, and peripheral nerves, the observed decrease in Na+-K+ pump concentration may be important for the pathophysiology of diabetes. We emphasize that quantification of Na+-K+-ATPase or the Na+-K+ pump in muscle and nerve tissue from diabetic animals should preferably be performed with either intact samples or crude homogenates of whole tissue.
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Nørgaard A, Baandrup U, Larsen JS, Kjeldsen K. Heart Na,K-ATPase activity in cardiomyopathic hamsters as estimated from K-dependent 3-O-MFPase activity in crude homogenates. J Mol Cell Cardiol 1987; 19:589-94. [PMID: 3041009 DOI: 10.1016/s0022-2828(87)80364-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The hamster hereditary cardiomyopathy provides a unique model for the study of membrane abnormalities during chronic congestive heart failure. It is associated with intracellular calcium accumulation, mitochondrial calcification and cell necrosis. Previous studies have shown a decrease in Na,K-ATPase activity purified from ventricle sarcolemma. The present study demonstrates a decrease in K-dependent 3-O-methylfluorescein phosphatase (3-O-MFPase) activity from 1.93 to 1.30 mumol/g wet wt. or 33% in crude homogenates from the left ventricle of 7-months-old cardiomyopathic hamsters as compared to control animals. This represents an equivalent decrease in Na, K-ATPase activity. The values are several times higher than previously published for membrane fractions of myocardium from the hamster. Concomitantly, there was an increase in intracellular Na-concentration of the myocardium of 42% whereas the K-concentration was unchanged. The decrease in Na,K-pump concentration may be of importance for the increase in intracellular sodium and ensuing calcifying necrosis observed in the myocardium of cardiomyopathic hamsters. It is emphasized that quantification of the Na,K-ATPase or Na,K-pump should preferably be performed using crude homogenates.
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Taddeucci TN, Goodman CD, Byrd RC, Carey TA, Horen DJ, Larsen JS, Gaarde C, Rapaport J, Welch TP, Sugarbaker E. Spin-flip decomposition of the spectrum for 90Zr(p,n) at Ep. Phys Rev C Nucl Phys 1986; 33:746-748. [PMID: 9953205 DOI: 10.1103/physrevc.33.746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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Krofcheck D, Sugarbaker E, Rapaport J, Wang D, Bahcall JN, Byrd RC, Foster CC, Goodman CD, Gaarde C, Larsen JS, Horen DJ, Taddeucci TN. Gamow-Teller strength function in 71Ge via the (p,n) reaction at medium energies. Phys Rev Lett 1985; 55:1051-1054. [PMID: 10031715 DOI: 10.1103/physrevlett.55.1051] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
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Goodman CD, Byrd RC, Carey TA, Horen DJ, Larsen JS, Gaarde C, Rapaport J, Welch TP, Sugarbaker E, Taddeucci TN. Measurements of Gamow-Teller strength distributions in masses 13 and 15. Phys Rev Lett 1985; 54:877-880. [PMID: 10031644 DOI: 10.1103/physrevlett.54.877] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
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Abstract
The effect of exercise of gradually increased intensity, i.e. 75 W for 20 min followed by 100 W for 20 min, on plasma renin concentration (PRC) and plasma aldosterone concentration (PAC) was studied in young patients with essential hypertension and normotensive control subjects. During exercise without previous sodium loading PRC and PAC increased to the same degree in both hypertensives and normotensives during light exercise; PRC increased further significantly in the normotensives (63 to 72 microIU/ml (medians), P less than 0.01) but not in the hypertensives (46 to 51 microIU/ml) during heavy exercise. PRC and PAC were significantly correlated during both 75 W (rho = 0.633, P less than 0.05) and 100 W (rho = 0.635, P less than 0.05) exercise in the normotensives, but not in the hypertensives. During exercise after loading with 500 ml sodium chloride (0.85 mol/l) PRC and PAC increased in both hypertensives (28 to 42 microIU/ml, P less than 0.01; 0.11 to 0.53 nmol/l, P less than 0.01) and normotensives (22 to 33 microIU/ml, P less than 0.02; 0.12 to 0.34 nmol/l, P less than 0.01), although to a considerably lower degree than without previous loading. PRC and PAC were, however, significantly higher in the hypertensive than in the normotensive group after exercise. It is suggested that the responsiveness of the renin-aldosterone system is abnormal during exercise in young patients with mild essential hypertension, both without and with previous intravenous sodium loading.
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Pedersen EB, Mogensen CE, Larsen JS. Effects of exercise on urinary excretion of albumin and beta 2-microglobulin in young patients with mild essential hypertension without treatment and during long-term propranolol treatment. Scand J Clin Lab Invest 1981; 41:493-8. [PMID: 6171861 DOI: 10.3109/00365518109090488] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
The effect of exercise on the urinary excretion of albumin, beta 2-microglobulin, renal plasma flow (RPF) and glomerular filtration rate (GFR) was studied in two groups of young patients with mild essential hypertension, one comprising nine untreated patients (1) and one comprising eight patients treated with propranolol (2), and in a group comprising ten normotensive healthy control subjects (3). The urinary excretion of albumin and beta 2-microglobulin, RPF and GFR were measured during four consecutive periods: a control period of 40 min; two exercise periods of 20 min each, with a load of 75 W and 100 W, respectively; and a control period. During exercise group 1 showed an increase in albumin excretion and a decrease in beta 2-microglobulin excretion, while group 2 showed an increase in albumin excretion during heavy exercise only and unchanged beta 2-microglobulin excretion, and group 3 showed unchanged albumin and beta 2-microglobulin excretion. RPF and GFR were reduced during exercise in all groups, most markedly in the hypertensive groups. During both exercise loads albumin excretion was higher and RPF was lower in group 1 than in 3. In group 2 albumin excretion was lower than in 1 during the light exercise load, whereas RPF and GFR were lower during both exercise loads. It is concluded that young patients with mild essential hypertension have both an abnormally high albumin excretion and an abnormally low RPF during exercise. During propranolol therapy urinary albumin excretion was partly normal. The changes in albumin excretion suggest glomerular leakage.
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Larsen JS, Pedersen EB. Comparison of the effects of propranolol and labetalol on renal haemodynamics at rest and during exercise in essential hypertension. Eur J Clin Pharmacol 1980; 18:135-9. [PMID: 7428793 DOI: 10.1007/bf00561580] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The effect of exercise on renal haemodynamics was examined in young patients with mild essential hypertension. Four groups of subjects were studied: 13 normotensive, healthy control subjects, and 15 untreated, 11 propranolol-treated, and 6 labetalol-treated patients. Renal plasma flow (RPF) and glomerular filtration rate (GFR) were measured during four consecutive periods, a pre-exercise control period, two exercise periods with loads of 450 kpm/min and 600 kpm/min, respectively, and a post-exercise control period. In the untreated patients RPF and GFR were lower during exercise than in the normotensive control subjects, whereas no significant differences were found at rest. In the propranolol-treated patients the reduction in RPF and GFR during exercise was more pronounced than in the untreated hypertensives. In the labetalol-treated patients however, RPF and GFR were reduced only to the same degree as in the untreated hypertensives. The reduced renal blood flow in propranolol-treated patients may be attributed to a compensatory increase in sympathetic activity caused by an impaired cardiac response to exercise. The lack of reduction in renal blood flow during labetalol therapy could partly be related to alpha-adrenergic blockade in the renal vascular bed induced by labetalol, and partly to the smaller reduction in cardiac output during labetalol than during propranolol therapy.
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Abstract
The pre- and postoperative results of ultrasonographic measurements on the axial ocular components in 10 phakic eyes with retinal detachment treated with encircling silicone rubber band are presented. A significant increase (P less than 0.001) in axial eye length from 0.62 to 1.24 mm (average: 0.98 mm) was found. The elongation of the eye was caused by a corresponding increase in the length of the vitreous cavity. No significant changes were found in the anterior segment of the eyes. These data demonstrate that the postoperative refractive change in a myopic direction, which an encircling procedure with moderate indentation often produces, is caused by an axial elongation of the eye.
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Abstract
The results of the ultrasonographic measurements of the ocular components in 40 emmetropic eyes from men of nearly the same age are presented and the possible relation between the axial eye length and the head size is discussed. A significant correlation was found between the axial eye length and the head circumference (P less than 0.001), between the axial eye length and the head length (P less than 0.01) and between the axial eye length and the head breadth (P less than 0.02). A significant correlation was also found between the axial eye length and the height of the subjects (P less than 0.01). It is suggested that such a correlation can explain not only the wide individual range of axial eye lengths in emmetropic eyes, but also the existing difference in axial eye length between the sexes. The mean eye length was 23.82 mm in 40 men and 23.02 mm in 10 women; both sexes were of the same age (20-30 years).
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Riser WH, Larsen JS. Influence of breed somatotypes on prevalence of hip dysplasia in the dog. J Am Vet Med Assoc 1974; 165:79-81. [PMID: 4834637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Larsen JS, Corley EA. Radiographic evaluations in a canine hip dysplasia control program. J Am Vet Med Assoc 1971; 159:989-92. [PMID: 5106440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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