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Brusen Villadsen A, Bundgaard-Nielsen C, Ambühl L, Tang Svendsen M, Søkilde Pedersen I, Stæhr Hansen E, Baandrup U, Blaakær J, Sørensen S. Prevalence and type distribution of human papillomavirus infections in Danish patients diagnosed with vulvar squamous cell tumors and precursors. Gynecol Oncol Rep 2021; 37:100828. [PMID: 34621943 PMCID: PMC8484492 DOI: 10.1016/j.gore.2021.100828] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 06/21/2021] [Accepted: 06/28/2021] [Indexed: 11/07/2022] Open
Abstract
Most precursor lesions of VSCC appear to be HPV associated. A noteworthy proportion of keratinizing tumors, normally considered HPV independent, are HPV positive. Our findings pose a challenge to the two-pathway model in vulvar cancer development. HPV-16 is found in the majority of VSCC and vulvar HSIL cases followed by HPV-33, which is the second most common type.
Objective To study the prevalence and type distribution of human papillomavirus (HPV) in patients with vulvar high-grade precancerous lesions and vulvar squamous cell carcinoma (VSCC). Methods Formalin-fixed and paraffin-embedded (FFPE) tissue samples from Danish patients diagnosed with vulvar precancerous lesions or VSCC in the period from 2010 to 2012 were obtained. HPV-DNA detection was carried out by the use of polymerase chain reaction (PCR) using GP5+/GP6+ primers and genotyped by sequencing. A systematic literature search on the PubMed database was performed to investigate the prevalence and genotype distribution worldwide. Results In the present study population (n = 149) 52 vulvar high-grade squamous intraepithelial lesions (HSIL), 2 differentiated vulvar intraepithelial neoplasia (dVIN), and 95 VSCC cases were identified. HPV was detected in 85 patients (57.0%). Overall, a higher proportion of the vulvar high-grade precancerous lesions were HPV positive compared to VSCC (83.6% vs. 42.1%, p < 0.001). Additionally, HSIL had a significantly higher HPV-positive rate compared to keratinizing VSCC (84.6% vs. 33.3%, p < 0.001). However, the HPV positivity was comparable between HSIL and non-keratinizing VSCC (84.6% vs. 82.4%, p = 0.825). One dVIN was HPV positive whereas the other was HPV negative. HPV-16 was the most common HPV type (68.2%), followed by HPV-33 (18.8%) and HPV-18 (8.2%). Conclusions Most vulvar HSIL and non-keratinizing VSCCs appear to be HPV associated. However, we find a high HPV association in keratinizing VSCC, which needs to be further studied. HPV-16 remains the predominant genotype, but HPV-33 also seems to play a role in the development of VSCC.
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Affiliation(s)
- Annemarie Brusen Villadsen
- Centre for Clinical Research, North Denmark Regional Hospital, Hjørring, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Caspar Bundgaard-Nielsen
- Centre for Clinical Research, North Denmark Regional Hospital, Hjørring, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Lea Ambühl
- Centre for Clinical Research, North Denmark Regional Hospital, Hjørring, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Majbritt Tang Svendsen
- Centre for Clinical Research, North Denmark Regional Hospital, Hjørring, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Inge Søkilde Pedersen
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.,Department of Molecular Diagnostics, Aalborg University Hospital, Aalborg, Denmark.,Clinical Cancer Research Center, Aalborg University Hospital, Aalborg, Denmark
| | | | - Ulrik Baandrup
- Centre for Clinical Research, North Denmark Regional Hospital, Hjørring, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Jan Blaakær
- Department of Obstetrics and Gynecology, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Suzette Sørensen
- Centre for Clinical Research, North Denmark Regional Hospital, Hjørring, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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Mollerup S, Asplund M, Friis-Nielsen J, Kjartansdóttir KR, Fridholm H, Hansen TA, Herrera JAR, Barnes CJ, Jensen RH, Richter SR, Nielsen IB, Pietroni C, Alquezar-Planas DE, Rey-Iglesia A, Olsen PVS, Rajpert-De Meyts E, Groth-Pedersen L, von Buchwald C, Jensen DH, Gniadecki R, Høgdall E, Langhoff JL, Pete I, Vereczkey I, Baranyai Z, Dybkaer K, Johnsen HE, Steiniche T, Hokland P, Rosenberg J, Baandrup U, Sicheritz-Pontén T, Willerslev E, Brunak S, Lund O, Mourier T, Vinner L, Izarzugaza JMG, Nielsen LP, Hansen AJ. High-Throughput Sequencing-Based Investigation of Viruses in Human Cancers by Multienrichment Approach. J Infect Dis 2020; 220:1312-1324. [PMID: 31253993 PMCID: PMC6743825 DOI: 10.1093/infdis/jiz318] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Accepted: 06/27/2019] [Indexed: 01/10/2023] Open
Abstract
Background Viruses and other infectious agents cause more than 15% of human cancer cases. High-throughput sequencing-based studies of virus-cancer associations have mainly focused on cancer transcriptome data. Methods In this study, we applied a diverse selection of presequencing enrichment methods targeting all major viral groups, to characterize the viruses present in 197 samples from 18 sample types of cancerous origin. Using high-throughput sequencing, we generated 710 datasets constituting 57 billion sequencing reads. Results Detailed in silico investigation of the viral content, including exclusion of viral artefacts, from de novo assembled contigs and individual sequencing reads yielded a map of the viruses detected. Our data reveal a virome dominated by papillomaviruses, anelloviruses, herpesviruses, and parvoviruses. More than half of the included samples contained 1 or more viruses; however, no link between specific viruses and cancer types were found. Conclusions Our study sheds light on viral presence in cancers and provides highly relevant virome data for future reference.
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Affiliation(s)
- Sarah Mollerup
- Centre for GeoGenetics, Natural History Museum of Denmark, University of Copenhagen, Denmark
| | - Maria Asplund
- Centre for GeoGenetics, Natural History Museum of Denmark, University of Copenhagen, Denmark
| | - Jens Friis-Nielsen
- Department of Bio and Health Informatics, Technical University of Denmark, Lyngby, Denmark
| | | | - Helena Fridholm
- Centre for GeoGenetics, Natural History Museum of Denmark, University of Copenhagen, Denmark
| | - Thomas Arn Hansen
- Centre for GeoGenetics, Natural History Museum of Denmark, University of Copenhagen, Denmark
| | - José Alejandro Romero Herrera
- Department of Bio and Health Informatics, Technical University of Denmark, Lyngby, Denmark.,Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | | | - Randi Holm Jensen
- Centre for GeoGenetics, Natural History Museum of Denmark, University of Copenhagen, Denmark
| | - Stine Raith Richter
- Centre for GeoGenetics, Natural History Museum of Denmark, University of Copenhagen, Denmark
| | - Ida Broman Nielsen
- Centre for GeoGenetics, Natural History Museum of Denmark, University of Copenhagen, Denmark
| | - Carlotta Pietroni
- Centre for GeoGenetics, Natural History Museum of Denmark, University of Copenhagen, Denmark
| | - David E Alquezar-Planas
- Centre for GeoGenetics, Natural History Museum of Denmark, University of Copenhagen, Denmark
| | - Alba Rey-Iglesia
- Centre for GeoGenetics, Natural History Museum of Denmark, University of Copenhagen, Denmark
| | - Pernille V S Olsen
- Centre for GeoGenetics, Natural History Museum of Denmark, University of Copenhagen, Denmark
| | - Ewa Rajpert-De Meyts
- Department of Growth and Reproduction, Copenhagen University Hospital (Rigshospitalet), Denmark
| | - Line Groth-Pedersen
- Department of Pediatrics and Adolescent Medicine, University Hospital Rigshospitalet, Denmark
| | - Christian von Buchwald
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, Copenhagen University Hospital
| | - David H Jensen
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, Copenhagen University Hospital
| | - Robert Gniadecki
- Department of Dermato-Venerology, Faculty of Health Sciences, Copenhagen University Hospital, Bispebjerg Hospital, Denmark
| | - Estrid Høgdall
- Department of Pathology, Herlev and Gentofte Hospital, University of Copenhagen, Denmark
| | - Jill Levin Langhoff
- Department of Pathology, Herlev and Gentofte Hospital, University of Copenhagen, Denmark
| | - Imre Pete
- National Institute of Oncology, Department of Gynecology, Budapest, Hungary
| | - Ildikó Vereczkey
- National Institute of Oncology, Department of Gynecology, Budapest, Hungary
| | - Zsolt Baranyai
- 1st Department of Surgery, Semmelweis University, Budapest, Hungary
| | - Karen Dybkaer
- Department of Clinical Medicine, Aalborg University, Denmark
| | | | | | - Peter Hokland
- Department of Clinical Medicine, Department of Haematology, Aarhus University Hospital, Denmark
| | - Jacob Rosenberg
- Department of Surgery, Herlev and Gentofte Hospital, University of Copenhagen, Denmark
| | - Ulrik Baandrup
- Center for Clinical Research, North Denmark Regional Hospital and Department of Clinical Medicine, Aalborg University, Hjørring, Denmark
| | - Thomas Sicheritz-Pontén
- Department of Bio and Health Informatics, Technical University of Denmark, Lyngby, Denmark.,Centre of Excellence for Omics-Driven Computational Biodiscovery, AIMST University, Kedah, Malaysia
| | - Eske Willerslev
- Centre for GeoGenetics, Natural History Museum of Denmark, University of Copenhagen, Denmark
| | - Søren Brunak
- Department of Bio and Health Informatics, Technical University of Denmark, Lyngby, Denmark.,Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Ole Lund
- Department of Bio and Health Informatics, Technical University of Denmark, Lyngby, Denmark
| | - Tobias Mourier
- Centre for GeoGenetics, Natural History Museum of Denmark, University of Copenhagen, Denmark
| | - Lasse Vinner
- Centre for GeoGenetics, Natural History Museum of Denmark, University of Copenhagen, Denmark
| | - Jose M G Izarzugaza
- Department of Bio and Health Informatics, Technical University of Denmark, Lyngby, Denmark
| | - Lars Peter Nielsen
- Department of Autoimmunology and Biomarkers, Statens Serum Institut, Copenhagen S, Denmark
| | - Anders Johannes Hansen
- Centre for GeoGenetics, Natural History Museum of Denmark, University of Copenhagen, Denmark
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Telinius N, Spinozzi D, Rasic D, Dapena I, Baandrup U, Miron A, Oellerich S, Hjortdal J. Göttingen Minipig is not a Suitable Animal Model for in Vivo Testing of Tissue-Engineered Corneal Endothelial Cell-Carrier Sheets and for Endothelial Keratoplasty. Curr Eye Res 2020; 45:945-949. [DOI: 10.1080/02713683.2019.1706747] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Affiliation(s)
- Niklas Telinius
- Department of Ophthalmology, Aarhus University Hospital, Aarhus, Denmark
| | - Daniele Spinozzi
- Netherlands Institute for Innovative Ocular Surgery, Rotterdam, The Netherlands
| | - Dusan Rasic
- Center for Clinical Research, Regional Hospital North Jutland, Hjørring, Denmark and Aalborg University, Aalborg, Denmark
| | - Isabel Dapena
- Netherlands Institute for Innovative Ocular Surgery, Rotterdam, The Netherlands
| | - Ulrik Baandrup
- Center for Clinical Research, Regional Hospital North Jutland, Hjørring, Denmark and Aalborg University, Aalborg, Denmark
| | - Alina Miron
- Netherlands Institute for Innovative Ocular Surgery, Rotterdam, The Netherlands
| | - Silke Oellerich
- Netherlands Institute for Innovative Ocular Surgery, Rotterdam, The Netherlands
| | - Jesper Hjortdal
- Department of Ophthalmology, Aarhus University Hospital, Aarhus, Denmark
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Warner TC, Baandrup U, Jacobsen R, Bøggild H, Aunsholt Østergaard PS, Hagstrøm S. Prevalence of nocturia and fecal and urinary incontinence and the association to childhood obesity: a study of 6803 Danish school children. J Pediatr Urol 2019; 15:225.e1-225.e8. [PMID: 30930018 DOI: 10.1016/j.jpurol.2019.02.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Accepted: 02/05/2019] [Indexed: 01/27/2023]
Abstract
INTRODUCTION Fecal and urinary incontinence are common disorders in children. Obesity and its associated comorbidities have become increasingly common, and a relation between obesity, nocturia, incontinence, and nocturnal enuresis has been suggested. OBJECTIVE This large scale population study aims to determine the prevalence of fecal incontinence (FI), daytime urinary incontinence (DUI), nocturnal enuresis (NE), and nocturia in children at school entry and in adolescence and to clarify whether obesity is associated to any of the aforementioned symptoms. STUDY DESIGN First-grade children and their parents and adolescents in the seventh to ninth grades were interviewed in relation to school nurse visits. The interview included questions on whether incontinence or nocturia were experienced at least once per month. The participants' age was recorded, and weight and height were measured. Body mass index (BMI) was calculated and age standardized by the use of BMI-standard deviation score (SDS), with reference to World Health Organization normative BMI data. Obesity was defined as BMI-SDS >2. Associations between obesity and incontinence and nocturia were quantified by odds ratio (OR). RESULTS Completed interview questionnaires and measurements were obtained from 4002 children (95.1%) in the child population and 2801 adolescents (84.4%) in the adolescent population. The mean age of children was 6.45 ± 0.39 years, and 4.4% were obese. Overall 11.2% reported FI, 21.8% DUI, 16.8% NE, and 31.4% experienced nocturia. Obesity was associated with FI in first-grade boys (OR 1.86 compared with normal weight). Mean age of adolescents was 13.9 ± 0.85 years, and 7.6% of adolescent boys and 5.5% of the girls were obese. Fecal incontinence was reported by 2.1% of the adolescents, 4.5% had DUI, 1.0% stated to have NE, and 32.3% reported nocturia. Obesity was significantly associated with nocturia in adolescents (OR 1.74-2.01). DISCUSSION The prevalence of nocturia seems constant throughout childhood and adolescent life; this has not previously been documented. Incontinence is very common at school entry, with DUI reported more frequently than enuresis by both children and adolescents. Obesity is associated with nocturia in adolescents and FI in first-grade boys, but no significant association between obesity and NE or DUI is found. Strength of this study is the very high participation rates, but the study does not reveal information on previous treatment, subtype, or severity of symptoms. CONCLUSIONS Incontinence is very common in children. One-third of both children and adolescents experience nocturia. Obesity is associated with FI in first-grade boys and nocturia in adolescents.
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Affiliation(s)
- T C Warner
- Center for Clinical Research, North Regional Hospital, Hjørring, Denmark.
| | - U Baandrup
- Center for Clinical Research, North Regional Hospital, Hjørring, Denmark.
| | - R Jacobsen
- Department of Pediatrics, Aalborg University Hospital, Denmark.
| | - H Bøggild
- Public Health and Epidemiology Group, Health Science and Technology, Aalborg University, Aalborg, Denmark; Unit of Epidemiology and Biostatistics, Aalborg University Hospital, Aalborg, Denmark.
| | | | - S Hagstrøm
- Center for Clinical Research, North Regional Hospital, Hjørring, Denmark; Department of Pediatrics, Aalborg University Hospital, Denmark.
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5
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Melgaard D, Baandrup U, Bøgsted M, Bendtsen MD, Kristensen MT. Early mobilisation of patients with community-acquired pneumonia reduce length of hospitalisation-a pilot study. J Phys Ther Sci 2018; 30:926-932. [PMID: 30034100 PMCID: PMC6047957 DOI: 10.1589/jpts.30.926] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Accepted: 04/25/2018] [Indexed: 01/06/2023] Open
Abstract
[Purpose] To examine if length of stay was reduced following an early mobilisation programme in patients with community-acquired pneumonia, and secondary, if such a program influenced short-term rehospitalisation and mortality rates. [Participants and Methods] Ninety seven consecutive patients (51% men; over all mean ± SD age 71.9 ± 16.5 years) with community-acquired pneumonia were included in the intervention group, and compared with a historical control group of 97 patients, matching at case level. Early mobilisation was defined as more than 20 minutes out of bed within 24 hours of hospitalisation. [Results] Eighty out of 97 patients in the intervention group were mobilised within 24 hours and length of stay for all patients was reduced with an average of 1.5 (95%CI: -0.2; 3.2) days compared to the control group. There was no significant difference between the two groups according to 30-day rehospitalisation and mortality. [Conclusion] An early mobilisation program seem to reduce the length of stay for patients with community-acquired pneumonia, and without an increase in short-term mortality and re-hospitalisation rates.
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Affiliation(s)
- Dorte Melgaard
- Center for Clinical Research, North Denmark Regional Hospital: Bispensgade 37, DK-9800 Hjørring, Denmark.,Department of Clinical Medicine, Aalborg University, Denmark
| | - Ulrik Baandrup
- Center for Clinical Research, North Denmark Regional Hospital: Bispensgade 37, DK-9800 Hjørring, Denmark.,Department of Clinical Medicine, Aalborg University, Denmark
| | - Martin Bøgsted
- Department of Haematology, Aalborg University Hospital, Denmark.,Department of Clinical Medicine, Aalborg University Hospital, Denmark
| | - Mette Dahl Bendtsen
- Department of Haematology, Aalborg University Hospital, Denmark.,Department of Clinical Medicine, Aalborg University Hospital, Denmark
| | - Morten Tange Kristensen
- Physical Medicine and Rehabilitation Research-Copenhagen (PMR-C), Departments of Physiotherapy and Orthopaedic Surgery, Copenhagen University Hospital, Denmark
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6
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Al-Saaidi RA, Rasmussen TB, Birkler RID, Palmfeldt J, Beqqali A, Pinto YM, Nissen PH, Baandrup U, Mølgaard H, Hey TM, Eiskjaer H, Bross P, Mogensen J. The clinical outcome of LMNA missense mutations can be associated with the amount of mutated protein in the nuclear envelope. Eur J Heart Fail 2018; 20:1404-1412. [PMID: 29943882 DOI: 10.1002/ejhf.1241] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 04/18/2018] [Accepted: 05/21/2018] [Indexed: 12/17/2022] Open
Abstract
AIMS Lamin A/C mutations are generally believed to be associated with a severe prognosis. The aim of this study was to investigate disease expression in three affected families carrying different LMNA missense mutations. Furthermore, the potential molecular disease mechanisms of the mutations were investigated in fibroblasts obtained from mutation carriers. METHODS AND RESULTS A LMNA-p.Arg216Cys missense mutation was identified in a large family with 36 mutation carriers. Disease expression was unusual with a late onset and a favourable prognosis. Two smaller families with severe disease expression were shown to carry a LMNA-p.Arg471Cys and LMNA-p.Arg471His mutation, respectively. LMNA gene and protein expression was investigated in eight different mutation carriers by quantitative reverse transcriptase polymerase chain reaction, Western blotting, immunohistochemistry, and protein mass spectrometry. The results showed that all mutation carriers incorporated mutated lamin protein into the nuclear envelope. Interestingly, the ratio of mutated to wild-type protein was only 30:70 in LMNA-p.Arg216Cys carriers with a favourable prognosis while LMNA-p.Arg471Cys and LMNA-p.Arg471His carriers with a more severe outcome expressed significantly more of the mutated protein by a ratio of 50:50. CONCLUSION The clinical findings indicated that some LMNA mutations may be associated with a favourable prognosis and a low risk of sudden death. Protein expression studies suggested that a severe outcome was associated with the expression of high amounts of mutated protein. These findings may prove to be helpful in counselling and risk assessment of LMNA families.
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Affiliation(s)
- Rasha A Al-Saaidi
- Research Unit for Molecular Medicine, Aarhus University and University Hospital, Aarhus, Denmark
| | | | - Rune I D Birkler
- Research Unit for Molecular Medicine, Aarhus University and University Hospital, Aarhus, Denmark
| | - Johan Palmfeldt
- Research Unit for Molecular Medicine, Aarhus University and University Hospital, Aarhus, Denmark
| | - Abdelaziz Beqqali
- Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | - Yigal M Pinto
- Heart Failure Research Center, Academic Medical Center, Amsterdam, The Netherlands
| | - Peter H Nissen
- Department of Clinical Biochemistry, Aarhus University Hospital, Aarhus, Denmark
| | - Ulrik Baandrup
- Centre for Clinical Research, North Denmark Regional Hospital/Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Henning Mølgaard
- Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark
| | - Thomas M Hey
- Department of Cardiology, Odense University Hospital, Odense, Denmark
| | - Hans Eiskjaer
- Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark
| | - Peter Bross
- Research Unit for Molecular Medicine, Aarhus University and University Hospital, Aarhus, Denmark
| | - Jens Mogensen
- Department of Cardiology, Odense University Hospital, Odense, Denmark
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7
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Melgaard D, Baandrup U, Bøgsted M, Bendtsen MD, Hansen T. Rehospitalisation and mortality after hospitalisation for orapharyngeal dysphagia and community-acquired pneumonia: A 1-year follow-up study. Cogent Medicine 2018. [DOI: 10.1080/2331205x.2017.1417668] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- Dorte Melgaard
- Center for Clinical Research, North Denmark Regional Hospital, Hjørring, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Ulrik Baandrup
- Center for Clinical Research, North Denmark Regional Hospital, Hjørring, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Martin Bøgsted
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
- Department of Hematology, Aalborg University Hospital, Aalborg, Denmark
| | - Mette Dahl Bendtsen
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
- Department of Hematology, Aalborg University Hospital, Aalborg, Denmark
| | - Tina Hansen
- Department of Physical and Occupational Therapy, Metropolitan University College, Copenhagen, Denmark
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8
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Ambühl LMM, Villadsen AB, Baandrup U, Dybkær K, Sørensen S. HPV16 E6 and E7 Upregulate Interferon-Induced Antiviral Response Genes ISG15 and IFIT1 in Human Trophoblast Cells. Pathogens 2017; 6:pathogens6030040. [PMID: 28869524 PMCID: PMC5617997 DOI: 10.3390/pathogens6030040] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 08/31/2017] [Accepted: 08/31/2017] [Indexed: 01/10/2023] Open
Abstract
Human papillomavirus (HPV) is suggested to infect trophoblasts in the placenta, and HPV infections are reported to be more prevalent in pregnancies with adverse outcomes. Results are however controversial, and studies investigating the molecular consequences of placental HPV infections are lacking. We studied HPV DNA localization in the placenta in cases of spontaneous abortion/spontaneous preterm delivery as well as in elective abortion/normal full-term delivery. Using in vitro assays, we investigated downstream effects of HPV16 E6 and E7 expression in trophoblast cells at the gene expression level in order to gain increased biological insight into the interaction between HPV and the cellular host. Fluorescent in situ hybridization (FISH), combined with fluorescent immunohistochemistry (FIHC) to target the trophoblast marker CK7 clearly showed, that HPV DNA resides within syncytiotrophoblast cells in the placenta. In vitro HPV16 E6 and E7-transfected trophoblasts were analyzed by RNA sequencing, and results were validated by reverse transcription real time polymerase chain reaction (RT-qPCR) for selected genes in cell lines, as well as in patient material. We show that HPV16 E6 and E7 upregulate interferon-induced antiviral response genes ISG15 and IFIT1 in a human trophoblast cell line two-days post-transfection. This is a response that is not observed when assessing the gene expression levels of the same genes in HPV16-positive placenta samples. Investigations on viral activity find that HPV16 E6 and E7 are not transcribed in patients, possibly suggesting that HPV16 syncytiotrophoblast infection may be latent. We conclude that HPV localizes to syncytiotrophoblast cells of the placenta, and that active expression of HPV16 E6 and E7 induce an immediate interferon-induced antiviral response in trophoblast cells, which is not present in HPV-positive placenta samples, suggesting latent infection.
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Affiliation(s)
- Lea M M Ambühl
- Center for Clinical Research, North Denmark Regional Hospital/Department of Clinical Medicine, Aalborg University, 9800 Hjørring, Denmark.
| | - Annemarie B Villadsen
- Center for Clinical Research, North Denmark Regional Hospital/Department of Clinical Medicine, Aalborg University, 9800 Hjørring, Denmark.
| | - Ulrik Baandrup
- Center for Clinical Research, North Denmark Regional Hospital/Department of Clinical Medicine, Aalborg University, 9800 Hjørring, Denmark.
| | - Karen Dybkær
- Department of Hematology, Aalborg University Hospital/Department of Clinical Medicine, Aalborg University, 9000 Aalborg, Denmark.
| | - Suzette Sørensen
- Center for Clinical Research, North Denmark Regional Hospital/Department of Clinical Medicine, Aalborg University, 9800 Hjørring, Denmark.
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9
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Ambühl LMM, Leonhard AK, Widen Zakhary C, Jørgensen A, Blaakaer J, Dybkaer K, Baandrup U, Uldbjerg N, Sørensen S. Human papillomavirus infects placental trophoblast and Hofbauer cells, but appears not to play a causal role in miscarriage and preterm labor. Acta Obstet Gynecol Scand 2017; 96:1188-1196. [PMID: 28699189 DOI: 10.1111/aogs.13190] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [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: 03/17/2017] [Accepted: 06/19/2017] [Indexed: 01/09/2023]
Abstract
INTRODUCTION Recently, an association between human papillomavirus infection and both spontaneous abortion and spontaneous preterm delivery was suggested. However, the reported human papillomavirus prevalence in pregnant women varies considerably and reliable conclusions are difficult. We aimed to investigate human papillomavirus infection in placental tissue of a Danish study cohort. Furthermore, we studied the cellular localization of human papillomavirus. MATERIAL AND METHODS In this prospective case-control study, placental tissue was analyzed for human papillomavirus infection by nested PCR in the following four study groups: full-term delivery (n = 103), spontaneous preterm delivery (n = 69), elective abortion (n = 54), and spontaneous abortion (n = 44). Moreover, human papillomavirus cellular target was identified using in situ hybridization. RESULTS Human papillomavirus prevalence in placental tissue was 8.7% in full-term deliveries, 8.8% in spontaneous preterm deliveries, 10.9% in spontaneous abortions, and 20.4% in elective abortions. Twelve different human papillomavirus types were detected, and placental human papillomavirus infection was associated to a disease history of cervical cancer. Human papillomavirus DNA was identified in trophoblast cells, cells of the placental villi mesenchyme including Hofbauer cells, and in parts of the encasing endometrium. CONCLUSION Placental human papillomavirus infections are not likely to constitute a risk factor for spontaneous preterm labor or spontaneous abortions in the Danish population, although an effect of human papillomavirus DNA in placental cells cannot be excluded.
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Affiliation(s)
- Lea M M Ambühl
- Center for Clinical Research, North Denmark Regional Hospital, Hjørring, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Anne K Leonhard
- Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark
| | - Carina Widen Zakhary
- Department of Obstetrics and Gynecology, North Denmark Regional Hospital, Hjørring, Denmark
| | - Annemette Jørgensen
- Department of Obstetrics and Gynecology, Aalborg University Hospital, Aalborg, Denmark
| | - Jan Blaakaer
- Department of Obstetrics and Gynecology, Odense University Hospital, Odense, Denmark
| | - Karen Dybkaer
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.,Department of Hematology, Aalborg University Hospital, Aalborg, Denmark
| | - Ulrik Baandrup
- Center for Clinical Research, North Denmark Regional Hospital, Hjørring, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Niels Uldbjerg
- Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark
| | - Suzette Sørensen
- Center for Clinical Research, North Denmark Regional Hospital, Hjørring, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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10
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Rasmussen T, Al-Saaidi R, Birkler R, Palmfeldt J, Beqqali A, Pinto Y, Baandrup U, Moelgaard H, Hey T, Eiskjaer H, Bross P, Mogensen J. P1607Lamin A/C missense mutations causing cardiomyopathy are associated with highly variable outcomes despite uniform disease mechanisms. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p1607] [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: 11/13/2022] Open
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11
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Amstrup Funder J, Christian Danielsen C, Baandrup U, Martin Bibby B, Carl Andelius T, Toft Brøndum E, Wang T, Michael Hasenkam J. How Heart Valves Evolve to Adapt to an Extreme-Pressure System: Morphologic and Biomechanical Properties of Giraffe Heart Valves. J Heart Valve Dis 2017; 26:63-71. [PMID: 28544833] [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: 06/07/2023]
Abstract
BACKGROUND Heart valves which exist naturally in an extreme-pressure system must have evolved in a way to resist the stresses of high pressure. Giraffes are interesting as they naturally have a blood pressure twice that of humans. Thus, knowledge regarding giraffe heart valves may aid in developing techniques to design improved pressure-resistant biological heart valves. METHODS Heart valves from 12 giraffes and 10 calves were explanted and subjected to either biomechanical or morphological examinations. Strips from the heart valves were subjected to cyclic loading tests, followed by failure tests. Thickness measurements and analyses of elastin and collagen content were also made. Valve specimens were stained with hematoxylin and eosin, elastic van Gieson stain, Masson's trichrome and Fraser-Lendrum stain, as well as immunohistochemical reactions for morphological examinations. RESULTS The aortic valve was shown to be 70% (95% CI 42-103%) stronger in the giraffe than in its bovine counterpart (p <0.001). No significant difference was found between mitral or pulmonary valves. After normalization for collagen, no significant differences were found in strength between species. The giraffe aortic valve was found to be significantly stiffer than the bovine aortic valve (p <0.001), with no significant difference between mitral and pulmonary valves. On a dry weight basis, the aortic (10.9%), pulmonary (4.3%), and mitral valves (9.6%) of giraffes contained significantly more collagen than those of calves. The elastin contents of the pulmonary valves (2.5%) and aortic valves (1.5%) were also higher in giraffes. CONCLUSIONS The greater strength of the giraffe aortic valve is most likely due to a compact collagen construction. Both, collagen and elastin contents were higher in giraffes than in calves, which would make giraffe valves more resistant to the high-pressure forces. However, collagen also stiffens and thickens the valves. The mitral leaflets showed similar (but mostly insignificant) trends in strength, stiffness, and collagen content.
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Affiliation(s)
| | | | - Ulrik Baandrup
- Centre for Clinical Research, Aalborg University, Denmark
- Department of Clinical Medicine, North Denmark Regional Hospital, Denmark
| | - Bo Martin Bibby
- Department of Biostatistics, Aarhus University, Aarhus, Denmark
| | - Ted Carl Andelius
- Department of Cardio-Thoracic and Vascular surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Emil Toft Brøndum
- Department of Oto-Rhino-Laryngology, Aarhus University Hospital, Aarhus, Denmark
| | - Tobias Wang
- Zoophysiology, Department of Bioscience, Aarhus University, Denmark
| | - J Michael Hasenkam
- Department of Cardio-Thoracic and Vascular surgery, Aarhus University Hospital, Aarhus, Denmark
- Department of Surgery, University of Witwatersrand, Johannesburg, South Africa
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12
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Damkjaer M, Wang T, Brøndum E, Østergaard KH, Baandrup U, Hørlyck A, Hasenkam JM, Smerup M, Funder J, Marcussen N, Danielsen CC, Bertelsen MF, Grøndahl C, Pedersen M, Agger P, Candy G, Aalkjaer C, Bie P. The giraffe kidney tolerates high arterial blood pressure by high renal interstitial pressure and low glomerular filtration rate. Acta Physiol (Oxf) 2015; 214:497-510. [PMID: 26010805 DOI: 10.1111/apha.12531] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [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: 04/15/2015] [Revised: 05/11/2015] [Accepted: 05/18/2015] [Indexed: 12/11/2022]
Abstract
BACKGROUND The tallest animal on earth, the giraffe (Giraffa camelopardalis) is endowed with a mean arterial blood pressure (MAP) twice that of other mammals. The kidneys reside at heart level and show no sign of hypertension-related damage. We hypothesized that a species-specific evolutionary adaption in the giraffe kidney allows normal for size renal haemodynamics and glomerular filtration rate (GFR) despite a MAP double that of other mammals. METHODS Fourteen anaesthetized giraffes were instrumented with vascular and bladder catheters to measure glomerular filtration rate (GFR) and effective renal plasma flow (ERPF). Renal interstitial hydrostatic pressure (RIHP) was assessed by inserting a needle into the medullary parenchyma. Doppler ultrasound measurements provided renal artery resistive index (RI). Hormone concentrations as well as biomechanical, structural and histological characteristics of vascular and renal tissues were determined. RESULTS GFR averaged 342 ± 99 mL min(-1) and ERPF 1252 ± 305 mL min(-1) . RIHP varied between 45 and 140 mmHg. Renal pelvic pressure was 39 ± 2 mmHg and renal venous pressure 32 ± 4 mmHg. A valve-like structure at the junction of the renal and vena cava generated a pressure drop of 12 ± 2 mmHg. RI was 0.27. The renal capsule was durable with a calculated burst pressure of 600 mmHg. Plasma renin and AngII were 2.6 ± 0.5 mIU L(-1) and 9.1 ± 1.5 pg mL(-1) respectively. CONCLUSION In giraffes, GFR, ERPF and RI appear much lower than expected based on body mass. A strong renal capsule supports a RIHP, which is >10-fold that of other mammals effectively reducing the net filtration pressure and protecting against the high MAP.
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Affiliation(s)
- M. Damkjaer
- Department of Cardiovascular and Renal Research; University of Southern Denmark; Odense Denmark
| | - T. Wang
- Department of Biological Sciences; Institute of Zoophysiology; Aarhus University; Aarhus Denmark
| | - E. Brøndum
- Department of Physiology; Institute of Biomedicine; Aarhus University; Aarhus Denmark
| | - K. H. Østergaard
- Centre for Clinical Research; Hjørring/Department of Clinical Medicine; Aalborg University; Denmark
| | - U. Baandrup
- Centre for Clinical Research; Hjørring/Department of Clinical Medicine; Aalborg University; Denmark
| | - A. Hørlyck
- Department of Radiology; Aarhus University Hospital; Aarhus Denmark
| | - J. M. Hasenkam
- Department of Cardiothoracic and Vascular Surgery; Institute of Clinical Medicine; Aarhus University Hospital; Aarhus Denmark
| | - M. Smerup
- Department of Cardiothoracic and Vascular Surgery; Institute of Clinical Medicine; Aarhus University Hospital; Aarhus Denmark
| | - J. Funder
- Department of Cardiothoracic and Vascular Surgery; Institute of Clinical Medicine; Aarhus University Hospital; Aarhus Denmark
| | - N. Marcussen
- Department of Clinical Pathology; University of Southern Denmark; Odense Denmark
| | - C. C. Danielsen
- Department of Anatomy; Institute of Biomedicine; Aarhus University; Aarhus Denmark
| | - M. F. Bertelsen
- Center for Zoo and Wild Animal Health; Copenhagen Zoo; Copenhagen Denmark
| | - C. Grøndahl
- Center for Zoo and Wild Animal Health; Copenhagen Zoo; Copenhagen Denmark
| | - M. Pedersen
- MR Research Centre; Institute of Clinical Medicine; Aarhus University Hospital; Aarhus Denmark
| | - P. Agger
- MR Research Centre; Institute of Clinical Medicine; Aarhus University Hospital; Aarhus Denmark
| | - G. Candy
- Department of Physiology and Medicine; University of the Witwatersrand; Johannesburg South Africa
| | - C. Aalkjaer
- Department of Physiology; Institute of Biomedicine; Aarhus University; Aarhus Denmark
- Department of Biomedicine; University of Copenhagen; Copenhagen Denmark
| | - P. Bie
- Department of Cardiovascular and Renal Research; University of Southern Denmark; Odense Denmark
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13
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Axelsen LN, Calloe K, Braunstein TH, Riemann M, Hofgaard JP, Liang B, Jensen CF, Olsen KB, Bartels ED, Baandrup U, Jespersen T, Nielsen LB, Holstein-Rathlou NH, Nielsen MS. Diet-induced pre-diabetes slows cardiac conductance and promotes arrhythmogenesis. Cardiovasc Diabetol 2015; 14:87. [PMID: 26169175 PMCID: PMC4504126 DOI: 10.1186/s12933-015-0246-8] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Accepted: 06/11/2015] [Indexed: 12/17/2022] Open
Abstract
Background Type 2 diabetes is associated with abnormal electrical conduction and sudden cardiac death, but the pathogenic mechanism remains unknown. This study describes electrophysiological alterations in a diet-induced pre-diabetic rat model and examines the underlying mechanism. Methods Sprague–Dawley rats were fed either high-fat diet and fructose water or normal chow and water for 6 weeks. The electrophysiological properties of the whole heart was analyzed by in vivo surface ECG recordings, as wells as ex vivo in Langendorff perfused hearts during baseline, ischemia and re-perfussion. Conduction velocity was examined in isolated tissue strips. Ion channel and gap junction conductances were analyzed by patch-clamp studies in isolated cardiomyocytes. Fibrosis was examined by Masson’s Trichrome staining and thin-layer chromatography was used to analyze cardiac lipid content. Connexin43 (Cx43) expression and distribution was examined by western blotting and immunofluorescence respectively. Results Following 6 weeks of feeding, fructose-fat fed rats (FFFRs) showed QRS prolongation compared to controls (16.1 ± 0.51 (n = 6) vs. 14.7 ± 0.32 ms (n = 4), p < 0.05). Conduction velocity was slowed in FFFRs vs. controls (0.62 ± 0.02 (n = 13) vs. 0.79 ± 0.06 m/s (n = 11), p < 0.05) and Langendorff perfused FFFR hearts were more prone to ventricular fibrillation during reperfusion following ischemia (p < 0.05). The patch-clamp studies revealed no changes in Na+ or K+ currents, cell capacitance or gap junctional coupling. Cx43 expression was also unaltered in FFFRs, but immunofluorescence demonstrated an increased fraction of Cx43 localized at the intercalated discs in FFFRs compared to controls (78 ± 3.3 (n = 5) vs. 60 ± 4.2 % (n = 6), p < 0.01). No fibrosis was detected but FFFRs showed a significant increase in cardiac triglyceride content (1.93 ± 0.19 (n = 12) vs. 0.77 ± 0.13 nmol/mg (n = 12), p < 0.0001). Conclusion Six weeks on a high fructose-fat diet cause electrophysiological changes, which leads to QRS prolongation, decreased conduction velocity and increased arrhythmogenesis during reperfusion. These alterations are not explained by altered gap junctional coupling, Na+, or K+ currents, differences in cell size or fibrosis.
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Affiliation(s)
- Lene Nygaard Axelsen
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, The Danish National Research Foundation Centre for Cardiac Arrhythmia, University of Copenhagen, Blegdamsvej 3B, Copenhagen, N DK-2200, Denmark.
| | - Kirstine Calloe
- Department of Veterinary Clinical and Animal Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Thomas Hartig Braunstein
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, Core Facility for Integrated Microscopy, University of Copenhagen, Copenhagen, Denmark
| | - Mads Riemann
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, The Danish National Research Foundation Centre for Cardiac Arrhythmia, University of Copenhagen, Blegdamsvej 3B, Copenhagen, N DK-2200, Denmark
| | - Johannes Pauli Hofgaard
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, The Danish National Research Foundation Centre for Cardiac Arrhythmia, University of Copenhagen, Blegdamsvej 3B, Copenhagen, N DK-2200, Denmark
| | - Bo Liang
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, The Danish National Research Foundation Centre for Cardiac Arrhythmia, University of Copenhagen, Blegdamsvej 3B, Copenhagen, N DK-2200, Denmark
| | - Christa Funch Jensen
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, The Danish National Research Foundation Centre for Cardiac Arrhythmia, University of Copenhagen, Blegdamsvej 3B, Copenhagen, N DK-2200, Denmark
| | - Kristine Boisen Olsen
- Department of Forensic Medicine, Section of Forensic Pathology, University of Copenhagen, Copenhagen, Denmark
| | - Emil D Bartels
- Department of Clinical Biochemistry, Rigshospitalet, Copenhagen, Denmark
| | - Ulrik Baandrup
- Centre for Clinical Research, Vendsyssel Hospital/Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Thomas Jespersen
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, The Danish National Research Foundation Centre for Cardiac Arrhythmia, University of Copenhagen, Blegdamsvej 3B, Copenhagen, N DK-2200, Denmark
| | - Lars Bo Nielsen
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, The Danish National Research Foundation Centre for Cardiac Arrhythmia, University of Copenhagen, Blegdamsvej 3B, Copenhagen, N DK-2200, Denmark.,Department of Clinical Biochemistry, Rigshospitalet, Copenhagen, Denmark
| | - Niels-Henrik Holstein-Rathlou
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, The Danish National Research Foundation Centre for Cardiac Arrhythmia, University of Copenhagen, Blegdamsvej 3B, Copenhagen, N DK-2200, Denmark
| | - Morten Schak Nielsen
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, The Danish National Research Foundation Centre for Cardiac Arrhythmia, University of Copenhagen, Blegdamsvej 3B, Copenhagen, N DK-2200, Denmark
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14
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Ylijoki-Sørensen S, Boldsen JL, Lalu K, Sajantila A, Baandrup U, Boel LWT, Ehlers LH, Bøggild H. Cost-consequence analysis of cause of death investigation in Finland and in Denmark. Forensic Sci Int 2014; 245:133-42. [PMID: 25447186 DOI: 10.1016/j.forsciint.2014.10.032] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Accepted: 10/20/2014] [Indexed: 10/24/2022]
Abstract
The 1990s 12-16% total autopsy rate in Denmark has until now declined to 4%, while in Finland, it has remained between 25 and 30%. The decision to proceed with a forensic autopsy is based on national legislation, but it can be assumed that the financing of autopsies influences the decision process. Only little is known about the possible differences between health economics of Finnish and Danish cause of death investigation systems. The aims of this article were to analyse costs and consequences of Finnish and Danish cause of death investigations, and to develop an alternative autopsy practice in Denmark with another cost profile. Data on cause of death investigation systems and costs were derived from Departments of Forensic Medicine, Departments of Pathology, and the National Police. Finnish and Danish autopsy rates were calculated in unnatural (accident, suicide, homicide and undetermined intent) and natural (disease) deaths, and used to develop an alternative autopsy practice in Denmark. Consequences for society were analysed. The estimated unit cost (€) for one forensic autopsy is 3.2 times lower in Finland than in Denmark (€1400 versus €4420), but in Finland the salaries for forensic pathologists working at the National Institute for Health and Welfare are not included in the unit cost. The unit cost for one medical autopsy is also lower in Finland than in Denmark; €700 versus €1070. In our alternative practice in Denmark, the forensic autopsy rate was increased from 2.2% to 8.5%, and the medical autopsy rate from 2.4% to 5.8%. Costs per 10,000 deaths were estimated to be 50% (±25%) higher than now; i.e. €3,678,724 (2,759,112-4,598,336), but would result in a lower unit cost for forensic autopsies €3,094 (2,320-3,868) and for medical autopsies €749 (562-936). This practice would produce a higher accuracy of national mortality statistics, which, consequently, would entail higher quality in public health, an accurate basis for decision-making in health politics, and better legislative safety in society. The implementation of this alternative practice in Denmark requires that legislation demands that forensic autopsy be performed if causality between unnatural death and cause of death cannot be clarified or if cause of death remains unknown. The Danish Health and Medicines Authority should provide guidelines that request a medical autopsy in natural deaths where more information about disease as a cause of death is needed. Our study results warrant similar health economic analyses of different cause of death investigations in other countries.
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Affiliation(s)
- Seija Ylijoki-Sørensen
- Department of Forensic Medicine, Aarhus University, Brendstrupgaardsvej 100, 8200 Aarhus N, Denmark
| | - Jesper Lier Boldsen
- ADBOU, Institute of Forensic Medicine, University of Southern Denmark, Lucernemarken 20, 5260 Odense S, Denmark.
| | - Kaisa Lalu
- National Institute for Health and Welfare, Forensic Medicine Unit, Helsinki Kytösuontie 11, 00300 Helsinki, Finland.
| | - Antti Sajantila
- Department of Forensic Medicine, Hjelt Institute, Helsinki University, Kytösuontie 11, 00014 Helsinki, Finland, and Institute of Applied Genetics, Department of Molecular and Medical Genetics, University of North Texas Health Science Center, Ft. Worth, Texas, USA.
| | - Ulrik Baandrup
- Centre for Clinical Research, Vendsyssel Hospital/Faculty of Medicine, Aalborg University, Bispensgade 37, 9800 Hjørring, Denmark.
| | - Lene Warner Thorup Boel
- Department of Forensic Medicine, Aarhus University, Brendstrupgaardsvej 100, 8200 Aarhus N, Denmark.
| | - Lars Holger Ehlers
- Department of Business and Management, Danish Center for Healthcare Improvements, Faculty of Social Sciences, Aalborg University, Fibigerstræde 11, Room 73, 9220 Aalborg, Denmark.
| | - Henrik Bøggild
- Public Health and Epidemiology Group, Department of Health Science and Technology, Aalborg University, Niels Jernes Vej 14, 3-209, 9220 Aalborg, Denmark.
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15
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Telinius N, Baandrup U, Rumessen J, Pilegaard H, Hjortdal V, Aalkjaer C, Boedtkjer DB. The human thoracic duct is functionally innervated by adrenergic nerves. Am J Physiol Heart Circ Physiol 2014; 306:H206-13. [DOI: 10.1152/ajpheart.00517.2013] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Lymphatic vessels from animals have been shown to be innervated. While morphological studies have confirmed human lymphatic vessels are innervated, functional studies supporting this are lacking. The present study demonstrates a functional innervation of the human thoracic duct (TD) that is predominantly adrenergic. TDs harvested from 51 patients undergoing esophageal and cardia cancer surgery were either fixed for structural investigations or maintained in vitro for the functional assessment of innervation by isometric force measurements and electrical field stimulation (EFS). Electron microscopy and immunohistochemistry suggested scarce diffuse distribution of nerves in the entire vessel wall, but nerve-mediated contractions could be induced with EFS and were sensitive to the muscarinic receptor blocker atropine and the α-adrenoceptor blocker phentolamine. The combination of phentolamine and atropine resulted in a near-complete abolishment of EFS-induced contractions. The presence of sympathetic nerves was further confirmed by contractions induced by the sympathomimetic and catecholamine-releasing agent tyramine. Reactivity to the neurotransmitters norepinephrine, substance P, neuropeptide Y, acetylcholine, and methacholine was demonstrated by exogenous application to human TD ring segments. Norepinephrine provided the most consistent responses, whereas responses to the other agonists varied. We conclude that the human TD is functionally innervated with both cholinergic and adrenergic components, with the latter of the two dominating.
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Affiliation(s)
- Niklas Telinius
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
- Department of Cardiothoracic Surgery, Aarhus University Hospital Skejby, Aarhus, Denmark
| | - Ulrik Baandrup
- Center for Clinical Research, Vendsyssel Hospital and Aalborg University, Aalborg, Denmark; and
| | - Jüri Rumessen
- Research Department and Department of Gastroenterology F, Gentofte Hospital, Copenhagen, Denmark
| | - Hans Pilegaard
- Department of Cardiothoracic Surgery, Aarhus University Hospital Skejby, Aarhus, Denmark
| | - Vibeke Hjortdal
- Department of Cardiothoracic Surgery, Aarhus University Hospital Skejby, Aarhus, Denmark
| | | | - Donna Briggs Boedtkjer
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
- Department of Cardiothoracic Surgery, Aarhus University Hospital Skejby, Aarhus, Denmark
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16
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Petersen KK, Hørlyck A, Østergaard KH, Andresen J, Broegger T, Skovgaard N, Telinius N, Laher I, Bertelsen MF, Grøndahl C, Smerup M, Secher NH, Brøndum E, Hasenkam JM, Wang T, Baandrup U, Aalkjaer C. Protection against high intravascular pressure in giraffe legs. Am J Physiol Regul Integr Comp Physiol 2013; 305:R1021-30. [DOI: 10.1152/ajpregu.00025.2013] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [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]
Abstract
The high blood pressure in giraffe leg arteries renders giraffes vulnerable to edema. We investigated in 11 giraffes whether large and small arteries in the legs and the tight fascia protect leg capillaries. Ultrasound imaging of foreleg arteries in anesthetized giraffes and ex vivo examination revealed abrupt thickening of the arterial wall and a reduction of its internal diameter just below the elbow. At and distal to this narrowing, the artery constricted spontaneously and in response to norepinephrine and intravascular pressure recordings revealed a dynamic, viscous pressure drop along the artery. Histology of the isolated median artery confirmed dense sympathetic innervation at the narrowing. Structure and contractility of small arteries from muscular beds in the leg and neck were compared. The arteries from the legs demonstrated an increased media thickness-to-lumen diameter ratio, increased media volume, and increased numbers of smooth muscle cells per segment length and furthermore, they contracted more strongly than arteries from the neck (500 ± 49 vs. 318 ± 43 mmHg; n = 6 legs and neck, respectively). Finally, the transient increase in interstitial fluid pressure following injection of saline was 5.5 ± 1.7 times larger ( n = 8) in the leg than in the neck. We conclude that 1) tissue compliance in the legs is low; 2) large arteries of the legs function as resistance arteries; and 3) structural adaptation of small muscle arteries allows them to develop an extraordinary tension. All three findings can contribute to protection of the capillaries in giraffe legs from a high arterial pressure.
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Affiliation(s)
- Karin K. Petersen
- Department of Radiology, Aarhus University Hospital, Skejby, Denmark
| | - Arne Hørlyck
- Department of Radiology, Aarhus University Hospital, Skejby, Denmark
| | - Kristine H. Østergaard
- Zoophysiology, Department of Bioscience, Aarhus University, Aarhus, Denmark
- Department of Pathology, Vendsyssel Hospital and Center for Clinical Research, Aalborg University, Denmark
| | | | | | - Nini Skovgaard
- Zoophysiology, Department of Bioscience, Aarhus University, Aarhus, Denmark
| | - Niklas Telinius
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - Ismael Laher
- Department of Pharmacology and Therapeutics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Mads F. Bertelsen
- Center for Zoo and Wild Animal Health, Copenhagen Zoo, Frederiksberg, Denmark
| | - Carsten Grøndahl
- Center for Zoo and Wild Animal Health, Copenhagen Zoo, Frederiksberg, Denmark
| | - Morten Smerup
- Department of CardioThoracic and Vascular Surgery and Institute of Clinical Medicine, Aarhus University Hospital, Skejby, Denmark; and
| | - Niels H. Secher
- Department of Anesthesiology, and The Copenhagen Muscle Research Center, Rigshopitalet, University of Copenhagen, Denmark
| | - Emil Brøndum
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - John M. Hasenkam
- Department of CardioThoracic and Vascular Surgery and Institute of Clinical Medicine, Aarhus University Hospital, Skejby, Denmark; and
| | - Tobias Wang
- Zoophysiology, Department of Bioscience, Aarhus University, Aarhus, Denmark
| | - Ulrik Baandrup
- Department of Pathology, Vendsyssel Hospital and Center for Clinical Research, Aalborg University, Denmark
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17
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Rasmussen JG, Frøbert O, Holst-Hansen C, Kastrup J, Baandrup U, Zachar V, Fink T, Simonsen U. Comparison of human adipose-derived stem cells and bone marrow-derived stem cells in a myocardial infarction model. Cell Transplant 2012; 23:195-206. [PMID: 23211469 DOI: 10.3727/096368912x659871] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Treatment of myocardial infarction (MI) with bone marrow-derived mesenchymal stem cells and recently also adipose-derived stem cells has shown promising results. In contrast to clinical trials and their use of autologous bone marrow-derived cells from the ischemic patient, the animal MI models are often using young donors and young, often immune-compromised, recipient animals. Our objective was to compare bone marrow-derived mesenchymal stem cells with adipose-derived stem cells from an elderly ischemic patient in the treatment of MI using a fully grown non-immune-compromised rat model. Mesenchymal stem cells were isolated from adipose tissue and bone marrow and compared with respect to surface markers and proliferative capability. To compare the regenerative potential of the two stem cell populations, male Sprague-Dawley rats were randomized to receive intramyocardial injections of adipose-derived stem cells, bone marrow-derived mesenchymal stem cells, or phosphate-buffered saline 1 week following induction of MI. After 4 weeks, left ventricular ejection fraction (LVEF) was improved in the adipose-derived stem cell group, and scar wall thickness was greater compared with the saline group. Adipose-derived as well as bone marrow-derived mesenchymal stem cells prevented left ventricular end diastolic dilation. Neither of the cell groups displayed increased angiogenesis in the myocardium compared with the saline group. Adipose-derived stem cells from a human ischemic patient preserved cardiac function following MI, whereas this could not be demonstrated for bone marrow-derived mesenchymal stem cells, with only adipose-derived stem cells leading to an improvement in LVEF. Neither of the stem cell types induced myocardial angiogenesis, raising the question whether donor age and health have an effect on the efficacy of stem cells used in the treatment of MI.
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Affiliation(s)
- Jeppe Grøndahl Rasmussen
- Department of Biomedicine, Pulmonary and Cardiovascular Pharmacology, Aarhus University, Aarhus, Denmark
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19
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Briggs Boedtkjer D, Rumessen J, Baandrup U, Skov Mikkelsen M, Telinius N, Pilegaard H, Aalkjaer C, Hjortdal V. Identification of interstitial Cajal-like cells in the human thoracic duct. Cells Tissues Organs 2012; 197:145-58. [PMID: 23147528 DOI: 10.1159/000342437] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/10/2012] [Indexed: 11/19/2022] Open
Abstract
Interstitial Cajal-like cells (ICLCs) are speculated to be pacemakers in smooth muscle tissues. While the human thoracic duct (TD) is spontaneously active, the origin of this activity is unknown. We hypothesized that ICLCs could be present in the TD and using histological techniques, immunohistochemistry and immunofluorescence we have investigated the presence of ICLCs, protein markers for ICLCs and the cellular morphology of the human TD. Transmission electron microscopy was employed to investigate ultrastructure. Methylene blue staining, calcium-dependent fluorophores and confocal microscopy were used to identify ICLCs in live tissue. Methylene blue stained cells with morphology suggestive of ICLCs in the TD. Immunoreactivity localized the ICLC protein markers c-kit, CD34 and vimentin to many cells and processes associated with smooth muscle cells (SMCs): coexpression of c-kit with vimentin or CD34 was observed in some cells. Electron microscopy analysis confirmed ICLCs as a major cell type of the human TD. Lymphatic ICLCs possess caveolae, dense bands, a patchy basal lamina, intermediate filaments and specific junctions to SMCs. ICLCs were ultrastructurally differentiable from other interstitial cells observed: fibroblasts, mast cells, macrophages and pericytes. Lymphatic ICLCs were localized to the subendothelial region of the wall as well as in intimate association with smooth muscle bundles throughout the media. ICLCs were morphologically distinct with multiple processes and also spindle shapes. Confocal imaging with calcium-dependent fluorophores corroborated cell morphology and localization observed in fixed tissues. Lymphatic ICLCs thus constitute a significant cell type of the human TD and physically interact with lymphatic SMCs.
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Nielsen SCA, Mourier T, Baandrup U, Søland TM, Bertelsen MF, Gilbert MTP, Nielsen LP. Probable transmission of coxsackie B3 virus from human to chimpanzee, Denmark. Emerg Infect Dis 2012; 18:1163-5. [PMID: 22709557 PMCID: PMC3376799 DOI: 10.3201/eid1807.111689] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
In 2010, a chimpanzee died at Copenhagen Zoo following an outbreak of respiratory disease among chimpanzees in the zoo. Identification of coxsackie B3 virus, a common human pathogen, as the causative agent, and its severe manifestation, raise questions about pathogenicity and transmissibility among humans and other primates.
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Arinell K, Sahdo B, Evans AL, Arnemo JM, Baandrup U, Fröbert O. Brown bears (Ursus arctos) seem resistant to atherosclerosis despite highly elevated plasma lipids during hibernation and active state. Clin Transl Sci 2012; 5:269-72. [PMID: 22686205 DOI: 10.1111/j.1752-8062.2011.00370.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Hibernation is an extreme physiological challenge for the brown bear (Ursus arctos) in which metabolism is based mainly on lipids. The study objective was to compare plasma lipids in hibernating and active free-ranging brown bears and relate them to arterial histopathology. Blood was drawn from seven immobilized free-ranging brown bears (three females, 2-3 years old) during hibernation in February and from the same bears while active in June and analyzed by enzymatic and automated hematology methods within 48 hours of sampling. Left anterior descending coronary arteries and aortic arches from 12 bears (six females, 1.5-12 years old) killed in hunting were examined by histopathology. Total plasma cholesterol decreased from hibernation to the active period (11.08 ± 1.04 mmol/L vs. 7.89 ± 1.96 mmol/L, P= 0.0028) as did triglyceride (3.16 ± 0.62 mmol/L vs. 1.44 ± 0.27 mmol/L, P= 0.00012) and LDL cholesterol (4.30 ± 0.71 mmol/L vs. 2.02 ± 1.03 mmol/L, P= 0.0075), whereas HDL cholesterol was unchanged. No atherosclerosis, fatty streaks, foam cell infiltration, or inflammation were seen in any arterial samples. Brown bears tolerate elevated cholesterol levels, obesity, physical inactivity, and circulatory slow flow during hibernation without signs of -atherosclerosis. This species might serve as a reverse translational model for atherosclerosis resistance.
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Affiliation(s)
- Karin Arinell
- Department of Cardiology, Örebro University Hospital, Örebro, Sweden
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Baandrup U. Comprehensive Cytopathology. Acta Cytol 2011. [DOI: 10.1159/000332325] [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] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Hoerlyck A, Petersen KK, Sloth E, Baandrup U, Bertelsen M, Broendum E, Candy G, Groendahl C, Hasenkam M, Secher N, Wang T, Oestergaard K, Aalkjaer C. Function of a sphincter‐like structure in the median artery of the giraffe foreleg. FASEB J 2011. [DOI: 10.1096/fasebj.25.1_supplement.1045.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Østergaard KH, Bertelsen MF, Brøndum ET, Aalkjær C, Hasenkam JM, Smerup M, Wang T, Nyengaard JR, Baandrup U. Pressure profile and morphology of the arteries along the giraffe limb. J Comp Physiol B 2011; 181:691-8. [DOI: 10.1007/s00360-010-0545-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2010] [Revised: 12/07/2010] [Accepted: 12/09/2010] [Indexed: 10/18/2022]
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Abstract
Reports of a possible relationship between Aleutian mink disease parvovirus (AMDV) and human infection are rare. However, 2 mink farmers with vascular disease and microangiopathy similar to that in mink with Aleutian disease were found to have AMDV-specific antibodies and AMDV DNA. These findings raise the suspicion that AMDV may play a role in human disease.
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Affiliation(s)
- Jørgen R Jepsen
- Department of Occupational Medicine, Hospital of South-Western Jutland, Østergade 81-83, DK-6700 Esbjerg, Denmark.
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Tang Y, Nyengaard JR, Andersen JB, Baandrup U, Gundersen HJG. The application of stereological methods for estimating structural parameters in the human heart. Anat Rec (Hoboken) 2009; 292:1630-47. [PMID: 19714657 DOI: 10.1002/ar.20952] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
This study describes and exemplifies generally applicable design-based stereological methods for obtaining quantitative estimates of the numbers and sizes of capillaries, cardiomyocytes, and cardiomyocyte nuclei in immersion-fixed human left ventricles (N = 6). The design-based stereological methods are valid in all cardiac investigations onto quantifying changes in structure and function as seen under various conditions such as during development, aging, hypertrophy, and following ischemia/reperfusion. The applied principles of unbiased stereology were as follows: 1) uniform random sampling was taken at all levels, also in respect to orientations, for estimates of length and mean sizes. 2) All global structural quantities were estimated as total quantity = density x volume of the left ventricle. As an example, the left ventricle contains 1.5 x 10(9) capillaries with a total length of just below 200 km. 3) Stereological methods were used for estimating the volume density, surface area density, and length density of capillaries and cardiomyocytes. The numerical density of cardiomyocyte nuclei and capillaries was estimated, using the optical and physical disector, respectively. 4) In all local quantities, "size" was estimated either directly, using unbiased estimators to obtain the average individual size and size distribution parameters, or indirectly, using the relationship that: average size = total quantity/total number. In the six hearts constituting this study, we observed the anticipated correlation between left ventricular volume and global estimates such as total number of capillaries. There were no correlation between local quantities and total left ventricular volume (e.g., average star volume of individual cardiomyocytes).
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Affiliation(s)
- Yong Tang
- Stereology and Electron Microscopy Research Laboratory, University of Aarhus, Aarhus, Denmark
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Brøndum E, Hasenkam JM, Secher NH, Bertelsen MF, Grøndahl C, Petersen KK, Buhl R, Aalkjær C, Baandrup U, Nygaard H, Smerup M, Stegmann F, Sloth E, Østergaard KH, Nissen P, Runge M, Pitsillides K, Wang T. Jugular venous pooling during lowering of the head affects blood pressure of the anesthetized giraffe. Am J Physiol Regul Integr Comp Physiol 2009; 297:R1058-65. [DOI: 10.1152/ajpregu.90804.2008] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [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]
Abstract
How blood flow and pressure to the giraffe's brain are regulated when drinking remains debated. We measured simultaneous blood flow, pressure, and cross-sectional area in the carotid artery and jugular vein of five anesthetized and spontaneously breathing giraffes. The giraffes were suspended in the upright position so that we could lower the head. In the upright position, mean arterial pressure (MAP) was 193 ± 11 mmHg (mean ± SE), carotid flow was 0.7 ± 0.2 l/min, and carotid cross-sectional area was 0.85 ± 0.04 cm2. Central venous pressure (CVP) was 4 ± 2 mmHg, jugular flow was 0.7 ± 0.2 l/min, and jugular cross-sectional area was 0.14 ± 0.04 cm2 ( n = 4). Carotid arterial and jugular venous pressures at head level were 118 ± 9 and −7 ± 4 mmHg, respectively. When the head was lowered, MAP decreased to 131 ± 13 mmHg, while carotid cross-sectional area and flow remained unchanged. Cardiac output was reduced by 30%, CVP decreased to −1 ± 2 mmHg ( P < 0.01), and jugular flow ceased as the jugular cross-sectional area increased to 3.2 ± 0.6 cm2 ( P < 0.01), corresponding to accumulation of ∼1.2 l of blood in the veins. When the head was raised, the jugular veins collapsed and blood was returned to the central circulation, and CVP and cardiac output were restored. The results demonstrate that in the upright-positioned, anesthetized giraffe cerebral blood flow is governed by arterial pressure without support of a siphon mechanism and that when the head is lowered, blood accumulates in the vein, affecting MAP.
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Affiliation(s)
| | - J. M. Hasenkam
- Institute of Clinical Medicine, Departments of CardioThoracic and Vascular Surgery, and
| | | | - M. F. Bertelsen
- Department of Large Animal Science, University of Copenhagen, and
- Center for Zoo and Wild Animal Health, Copenhagen Zoo, Copenhagen, Denmark
| | - C. Grøndahl
- Center for Zoo and Wild Animal Health, Copenhagen Zoo, Copenhagen, Denmark
| | | | - R. Buhl
- Department of Large Animal Science, University of Copenhagen, and
| | | | - U. Baandrup
- Institute of Pathology, Aarhus University Hospital, Aarhus, Denmark
- Vendsyssel Hospital, Hjørring, Denmark
| | - H. Nygaard
- Institute of Clinical Medicine, Departments of CardioThoracic and Vascular Surgery, and
- Engineering College of Aarhus, Aarhus, Denmark
| | - M. Smerup
- Institute of Clinical Medicine, Departments of CardioThoracic and Vascular Surgery, and
| | - F. Stegmann
- Department of Companion Animal Clinical Studies, University of Pretoria, Pretoria, South Africa; and
| | - E. Sloth
- Institute of Clinical Medicine, Departments of CardioThoracic and Vascular Surgery, and
| | | | - P. Nissen
- Department of Anesthesiology, Rigshospitalet,
| | - M. Runge
- Department of Anesthesiology, Rigshospitalet,
| | | | - T. Wang
- Zoophysiology, Department of Biological Sciences, Aarhus University, Aarhus, Denmark
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Abstract
A case of fatal mumps myocarditis in a 38-year-old male is reported. The disease started with orchitis, and severe cardiac symptoms developed within 1 1/2 month. The patient died 5 months later from congestive heart failure. The possible interrelation between late stages of viral myocarditis and dilated (congestive) cardiomyopathy is emphasized.
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la Cour Petersen E, Vesterby A, Baandrup U, Nielsen JL. Correlation of Electrophysiology and morphology in myocardial sarcoidosis. A case report. Acta Med Scand 2009; 211:407-10. [PMID: 7113753 DOI: 10.1111/j.0954-6820.1982.tb01970.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
A 44-year-old man with systemic sarcoidosis for 11 years developed myocardial sarcoidosis with left bundle branch block and recurrent ventricular tachycardia prior to death. Autopsy showed granulomas and fibrosis in the myocardium including the left ventricular free wall, septum and His bundle, particular the left bundle branch. This is in accordance with the ECG findings.
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Brauer C, Baandrup U, Jacobsen P, Krasnik M, Olsen JH, Pedersen JH, Rasmussen TR, Schlünssen V, Sherson D, Svolgaard B, Sørensen JB, Omland O. [Screening for asbestos-related conditions]. Ugeskr Laeger 2009; 171:433-436. [PMID: 19208334] [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: 05/27/2023]
Abstract
Screening programs for early detection of asbestos-related cancer have been considered. Conventional X-ray, computed tomography of the thorax, and the biomarkers osteopontin and mesothelin have been critically reviewed in the literature, together with survival data from screening programs in asbestos-exposed populations. Data do not currently support implementation of screening programs for asbestos-exposed persons in Denmark. Since mesothelioma is most often an occupational disease, these patients should be admitted to an occupational clinic for aetiological evaluation.
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Ingemann-Hansen O, Lidang M, Niemann I, Dinesen J, Baandrup U, Svanholm H, Petersen L. Screening history of women with cervical cancer: a 6-year study in Aarhus, Denmark. Br J Cancer 2008; 98:1292-4. [PMID: 18334971 PMCID: PMC2359645 DOI: 10.1038/sj.bjc.6604293] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
To identify possible weaknesses in cervical screening in Aarhus County, 10 years after the programme was introduced, screening histories were examined. A major problem for the screening programme was that 31% of women were never screened and 61% under-screened, the latter group being significantly dominated by older women and high-stage tumours.
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Affiliation(s)
- O Ingemann-Hansen
- Institute of Pathology, Aarhus University Hospital, Norrebrogade 44, 8000 Aarhus C, Denmark.
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Krarup NH, Poulsen SH, Baandrup U, Klaaborg KE, Egeblad H. Aorto-mitral inflammation in rheumatological disease: Transoesophageal echocardiographic presentation. European Journal of Echocardiography 2007; 8:346-51. [PMID: 16880008 DOI: 10.1016/j.euje.2006.06.010] [Citation(s) in RCA: 2] [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] [Received: 04/02/2006] [Revised: 06/16/2006] [Accepted: 06/22/2006] [Indexed: 11/22/2022]
Abstract
Thickening of the aortic root and anterior mitral leaflet has been described in patients with aortic valve insufficiency associated with ankylosing spondylitis. We report identical findings made by transthoracic and transoesophageal echocardiography in three patients with inflammatory, non-infective aorto-mitral pathology as manifestation of various rheumatological disorders. All three patients had significant aortic valve incompetence. All three had thickened walls of the sinuses of Valsalvae and a thickened anterior mitral leaflet, in one case with chordal rupture. These findings were confirmed at open heart surgery, and further characterized by histological examination.
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Affiliation(s)
- Niels Henrik Krarup
- Department of Cardiology, Aarhus University Hospital, Skejby, 8200 Aarhus N, Denmark.
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33
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Skov BG, Baandrup U, Jakobsen GK, Kiss K, Krasnik M, Rossen K, Vilmann P. Cytopathologic diagnoses of fine-needle aspirations from endoscopic ultrasound of the mediastinum. Cancer 2007; 111:234-41. [PMID: 17570515 DOI: 10.1002/cncr.22866] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.5] [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: 11/10/2022]
Abstract
BACKGROUND Endoscopic ultrasound-guided fine-needle aspiration biopsy through the esophagus (EUS-FNA) or the bronchial tree (endobronchial ultrasound guided transbronchial needle aspiration [EBUS-TBNA]) may be used to obtain specimens from mediastinal structures. The accuracy of this procedure has been well documented. However, no studies have studied the reproducibility of the pathologic assessment of the aspirated material. METHODS A total of 102 slides from EUS-FNA or EBUS-TBNA were assessed 2 times by 4 pathologists who classified each slide to 1 of 5 diagnostic categories and judged if the aspirate came from a lymph node. Between the 2 rounds the criteria to be used in the assessment of the slides were reviewed in a limited education session. The 4 observers had at least 15 years of pathology experience, but their experience in EUS-FNA and/or EBUS-TBNA varied from almost none to more than 10 years. The kappa statistic was applied for the analysis of reproducibility. RESULTS The reproducibility of the diagnoses in the first round was good to excellent (kappa, 0.52-0.89). The teaching session led to a significant improvement of the reproducibility between the least and the most experienced observers (kappa ranges of 0.52-0.55 in the first round improved to 0.65-0.71 in the second round). CONCLUSIONS The reproducibility of the diagnosis on EBUS-TBNA and EUS-FNA is excellent among pathologists experienced with these types of samples. Pathologists who are generally experienced but have little experience with EBUS-TBNA and EUS-FNA show a steep learning curve. From a pathologic point of view, EBUS-TBNA and EUS-FNA are feasible, but only experienced pathologists should do the assessments.
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Affiliation(s)
- Birgit Guldhammer Skov
- Department of Pathology, Herlev University Hospital, Division Gentofte, Hellerup, Denmark.
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Zebis LPR, Christensen TD, Bøttcher M, Eiskjaer HE, Lorenzen AG, Ilkjaer LB, Baandrup U. [Severe anterior myocardial infarction caused by amphetamine abuse]. Ugeskr Laeger 2007; 169:423-4. [PMID: 17280637] [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: 05/13/2023]
Abstract
We present a case showing that intake of amphetamine can cause severe anterior myocardial infarction with acute severe pump failure. Acute angiography revealed massive proximal thrombotic occlusion of the LAD, the first diagonal branch and septal branches in a 28-year-old man. Thrombectomy, balloon dilation and stenting were performed. Spasm thrombus interplay was found to be the likely mechanism. Due to the massive infarction, extremely depressed left ventricular performance and hemodynamic instability, the patient underwent successful heart transplantation. The patient was readmitted to hospital six months later due to chronic vascular rejection of the heart, which lead to the death of the young man.
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Moesgaard SG, Olsen LH, Viuff BM, Baandrup U, Pedersen LG, Thomsen PD, Pedersen HD, Harrison AP. Increased nitric oxide release and expression of endothelial and inducible nitric oxide synthases in mildly changed porcine mitral valve leaflets. J Heart Valve Dis 2007; 16:67-75. [PMID: 17315385] [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: 05/14/2023]
Abstract
BACKGROUND AND AIM OF THE STUDY Little is known of the local role of nitric oxide (NO) in heart valves in relation to heart valve diseases. The study aim was to examine NO release and the expression of both endothelial nitric oxide synthase (eNOS) and inducible nitric oxide synthase (iNOS) in relation to early local changes in porcine mitral valves. METHODS A histological evaluation of mitral valve leaflets from slaughter pigs and sows was made, and the expression of eNOS and iNOS protein measured using immunohistochemistry. Furthermore, mRNA levels of eNOS and iNOS were measured using real-time RT-PCR. A calibrated NO-specific electrode was used to measure local NO release in specific regions of the anterior mitral leaflet from slaughter pigs and sows interchordally at the tip of the leaflet (region A), at the chordal insertion (region B), and at the center of the leaflet (region C). RESULTS Leaflets from sows had an increased accumulation of mucopolysaccharides (MPS) compared to those from slaughter pigs. Furthermore, mRNA levels of eNOS and iNOS were significantly increased in region C due to very high levels of expression in some sow leaflets. NO release in the sow mitral valve leaflet was increased in regions B and C compared to that in region A. CONCLUSION The relative distribution of NO release is increased in regions of porcine mitral valve leaflets with deposition of MPS and defraction of the valve structure, which may reflect changes in both eNOS and iNOS expression.
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Affiliation(s)
- Sophia G Moesgaard
- Department of Basic Animal and Veterinary Sciences, The Royal Veterinary and Agricultural University, 7 Groennegaardsvej, 1870 Frederiksberg, Denmark.
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Jensen AS, Baandrup U, Hasenkam JM, Kundu T, Jørgensen CS. Distribution of the microelastic properties within the human anterior mitral leaflet. Ultrasound Med Biol 2006; 32:1943-8. [PMID: 17169706 DOI: 10.1016/j.ultrasmedbio.2006.06.011] [Citation(s) in RCA: 12] [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] [Subscribe] [Scholar Register] [Received: 10/26/2005] [Revised: 06/09/2006] [Accepted: 06/15/2006] [Indexed: 05/13/2023]
Abstract
Knowledge of the biomechanical properties of the mitral valve leaflets and their relation to histologic structure is of importance for understanding the leaflet movement characteristics under normal and pathologic conditions, but such knowledge is not yet available. The aim of this study was to determine biomechanical properties of the human anterior mitral leaflet on a microscopic scale. We used scanning acoustic microscopy (SAM) to examine the human anterior mitral leaflet. Sections of fixed human anterior mitral leaflet tissue were obtained from postmortem human anterior mitral leaflets (n = 5). We measured the speed of sound (nu(L)) in each histologic layer in three regions-of-interest (ROIs): these were at the annular edge, at the valve midpoint and close to the free edge. nu(L) varied in the three histologic layers (p < 0.01). It was higher in the fibrous layer (1.76 km/s) compared with the atrial layer (1.75 km/s) and ventricular layer (1.73 km/s). Also, nu(L) differed between positions along the length of the annulus-free edge line (p < 0.01), showing a decline from the annular edge (1.76 km/s) to the free edge (1.73 km/s), both as a whole and also within the atrial and the fibrous layer. These results demonstrate that the fibrous layer is stiffer than the atrial and ventricular layer and that the leaflet as a whole and within the atrial and the fibrous layer is stiffer at the annulus part in comparison with those near the free edge. (E-mail: ).
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Gravholt CH, Landin-Wilhelmsen K, Stochholm K, Hjerrild BE, Ledet T, Djurhuus CB, Sylvén L, Baandrup U, Kristensen BØ, Christiansen JS. Clinical and epidemiological description of aortic dissection in Turner's syndrome. Cardiol Young 2006; 16:430-6. [PMID: 16984695 DOI: 10.1017/s1047951106000928] [Citation(s) in RCA: 166] [Impact Index Per Article: 9.2] [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] [Accepted: 01/04/2006] [Indexed: 01/15/2023]
Abstract
BACKGROUND Women with Turner's syndrome have an increased risk of congenital cardiac malformations, ischaemic heart disease, hypertension and stroke. Aortic dissection seems to occur with increased frequency. AIM To describe in more detail aortic dissection as encountered in Turner's syndrome, giving attention to clinical, histological and epidemiological aspects. MATERIALS AND METHODS Based on a retrospective study, we describe the clinical, karyotypic, and epidemiological aspects of aortic dissection as encountered in cases of Turner's syndrome seen in Denmark and Sweden. RESULTS The median age at onset of aortic dissection in 18 women was 35 years, ranging from 18 to 61 years. Fourteen of 18 women had a 45,X karyotype, while 2 patients had 45,X/45,XY, and 2 had the 45,X/46,X+r(X) complement, respectively. Echocardiography was performed in 10 of 18 patients before their acute illness, and showed signs of congenital cardiac disease, with either bifoliate aortic valves, dilation of the aortic root, or previous aortic coarctation evident in most patients. In 5 patients evidence of a bifoliate aortic valve was conclusive. Hypertension was present in 5 of 18 patients, while 10 of the patients died from aortic dissection, of so-called type A in 6, type B in 3, while in the final case the origin of dissection could not be determined. Biochemical analysis showed altered ratio between type I and type III collagen. Histology showed cystic medial necrosis in 3 of 7 cases. We estimated an incidence of dissection of 36 per 100,000 Turner's syndrome years, compared with an incidence of 6 per 100,000 in the general population, and a cumulated rate of incidence of 14, 73, 78, and 50 per 100,000 among 0-19, 20-29, 30-39, and 40+ year olds, respectively. CONCLUSION Aortic dissection is extremely common in the setting of Turner's syndrome, and occurs early in life. Patients with Turner's syndrome should be offered a protocol for clinical follow-up similar to that provided for patients with Marfan syndrome, and each clinic should embrace a programme for follow-up.
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Affiliation(s)
- Claus Højbjerg Gravholt
- Medical department M (Endocrinology and Diabetes) and Medical Research Laboratories, Arhus Sygehus, Arhus University Hospital, Denmark.
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Rasmussen K, Madsen HH, Rasmussen F, Rasmussen TR, Baandrup U, Pilegaard HK, Pedersen U, Palshof T, Rehling M. The value of HRCT and Tc-depreotide in the evaluation of pulmonary lesions. J Thorac Oncol 2006; 1:296-301. [PMID: 17409873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Affiliation(s)
- Karin Rasmussen
- Department of Clinical Physiology and Nuclear Medicine, Aarhus University Hospital, Aarhus, Denmark
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Rasmussen K, Madsen HH, Rasmussen F, Rasmussen TR, Baandrup U, Pilegaard HK, Pedersen U, Palshof T, Rehling M. The Value of HRCT and Tc-Depreotide in the Evaluation of Pulmonary Lesions. J Thorac Oncol 2006. [DOI: 10.1016/s1556-0864(15)31584-7] [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] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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40
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Jensen ML, Baandrup U. A comment on terminology in cervical cytology and terminology discussions. Cytopathology 2005; 16:153. [PMID: 15924614 DOI: 10.1111/j.1365-2303.2005.00229.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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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P-Codrea Tigaran S, Dalager-Pedersen S, Baandrup U, Dam M, Vesterby-Charles A. Sudden unexpected death in epilepsy: is death by seizures a cardiac disease? Am J Forensic Med Pathol 2005; 26:99-105. [PMID: 15897710] [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: 05/02/2023]
Abstract
RESULTS Sudden unexpected death in epilepsy (SUDEP) gains more and more acknowledgment across the various interdisciplinary fields. Accordingly, we performed in a prospective setting a case-control study of all SUDEP cases in a well-defined part of Denmark (Northern Jutland), between January 1998 and September 2000. We attempted to look into the cardiopathologic mechanism behind this phenomenon by assessing the degree of myocardial fibrosis in SUDEP patients versus controls. The histologic evaluation was possible in 65% of the cases (15/23) whose death was attributed to SUDEP and in 71% (15/21) of controls. Forty percent of the SUDEP cases (6/15) presented several foci of fibrotic changes in the deep and subendocardial myocardium in contrast to 1 control (6.6%, P = 0.03). None of the subjects from the SUDEP group showed fibrotic changes in their conduction system as compared with 1 control (6.6%). The quantitative evaluation of fibrosis demonstrated a trend toward more fibrosis in the deep and subendocardial myocardium of the SUDEP cases. Forty percent of cases in the SUDEP group were men (6/15), characteristically young at time of death (mean age 38 years) and with a late epilepsy onset (mean age 21 years). Antemortem, 73% of the SUDEP patients (11/15) had experienced infrequent seizures (self-reported). We conclude that the SUDEP cases displayed significant fibrosis of the myocardium when this was assessed by qualitative means. This fibrosis may be the consequence of myocardial ischemia as a direct result of repetitive epileptic seizures, which, associated with the ictal sympathetic storm, may lead to lethal arrhythmias.
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Baandrup U. Rheumatic fever reappraised. Chin Med J (Engl) 2005; 118:360-1. [PMID: 15780203] [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: 05/02/2023] Open
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Voldstedlund M, Pedersen LN, Baandrup U, Fuursted K. [Whipple's disease--a cause of culture-negative endocarditis]. Ugeskr Laeger 2004; 166:3731-2. [PMID: 15508299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
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Charles AV, Baandrup U, Melsen F. [Research on the dead]. Ugeskr Laeger 2004; 166:2356-9. [PMID: 15281578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Affiliation(s)
- Annie Vesterby Charles
- Aarhus Universitet, Retsmedicinsk Institut, og Arhus Universitetshospital, Arhus Sygehus, Patologisk Institut.
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Jensen ML, Baandrup U. [The diagnostic value of the histopathological examination in the investigation of liver tumors]. Ugeskr Laeger 2004; 166:1917; author reply 1918. [PMID: 15202385] [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: 04/29/2023]
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Honoré B, Baandrup U, Vorum H. Heterogeneous nuclear ribonucleoproteins F and H/H' show differential expression in normal and selected cancer tissues. Exp Cell Res 2004; 294:199-209. [PMID: 14980514 DOI: 10.1016/j.yexcr.2003.11.011] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2003] [Revised: 10/24/2003] [Indexed: 12/12/2022]
Abstract
The heterogeneous nuclear ribonucleoproteins (hnRNPs) F and H/H', containing the quasi-RNA recognition motif (qRRM) domains, are implicated in several steps of pre-mRNA processing and in cellular differentiation. We have compared a set of tissues and found striking differences in their levels of expression as well as in the nuclear versus the cytoplasmic distribution. Generally, hnRNP F is broadly expressed in many tissues with extremely strong expression in the prostate gland while hnRNP H/H' shows a more restricted degree of expression with low expression in some tissues, for example, liver, exocrine acini of the pancreas, thyroid gland and heart. At the cellular level, hnRNP F is, with few exceptions, predominantly expressed in the cytoplasm while hnRNP H/H' is more abundant in the nuclei. A quite pronounced heterogeneous expression pattern is seen in the proximal tubules of the kidney where hnRNP F is present at moderate cytoplasmic levels while hnRNP H/H' is undetectable, whereas both proteins are more evenly expressed in distal tubules and collecting ducts. Generally, tumor tissues reveal a broad expression of hnRNP F in the nuclei as well as in the cytoplasm while hnRNP H/H' is expressed at higher levels in the nuclei than in the cytoplasm. Up-regulation of hnRNP H/H' is found in a few tissues that normally express low cytoplasmic levels of hnRNP H/H', for example, adenocarcinoma of the pancreas, hepatocellular carcinoma and gastric carcinoma. hnRNP F is down-regulated in hepatocellular carcinoma and up-regulated in gastric carcinoma. The present study indicates the important potential role of this subset of hnRNPs on the gene expression in many tissues.
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Affiliation(s)
- Bent Honoré
- Department of Medical Biochemistry, University of Aarhus, DK-8000 Aarhus C, Denmark.
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Olsen LH, Mortensen K, Martinussen T, Larsson LI, Baandrup U, Pedersen HD. Increased NADPH-diaphorase activity in canine myxomatous mitral valve leaflets. J Comp Pathol 2003; 129:120-30. [PMID: 12921717 DOI: 10.1016/s0021-9975(03)00019-7] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.7] [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: 12/23/2022]
Abstract
Comparable pathological changes in the mitral valve have been described in dogs, pigs and human patients with myxomatous mitral valve disease (MMVD), i.e., primary mitral valve prolapse. The progressive myxomatous changes are probably a response to repeated impact on the leaflets, and endothelial stress or damage probably plays a central role in the pathogenesis. Little, however, is known about the vasoactive substances that mediate the subendothelial changes. The aim of this study was to investigate the expression of nitric oxide synthase (NOS) in canine mitral valve leaflets and to relate the findings to MMVD changes. The mitral valve was taken post mortem from 12 dogs (six males and six females) and a whole valve NADPH (the reduced form of nicotinamide-adenine dinucleotide phosphate) diaphorase (NADPH-d) reaction was performed. Macroscopical (semiquantitative) and microscopical (computer image analysis) evaluations of the staining due to NADPH-d activity were performed at four specific areas of the valve and related to microscopical signs of MMVD and gross signs of thickening or prolapse, or both. Macroscopically, the NADPH-d colour grade was correlated with the degree of MMVD (P=0.01). In addition, endothelial NADPH-d staining intensity was correlated with macroscopical signs of disease (P=0.004) as well as with collagen degeneration (P=0.008) and deposition of mucopolysaccharides (P=0.02). Age, gender and specific area of the valve did not seem to influence the NADPH-d activity. In conclusion, increased NADPH-d activity, suggesting increased NOS expression, was found in areas of the mitral valve with myxomatous changes. This indicates that nitric oxide (NO) may play a role in the pathogenesis of MMVD in dogs.
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Affiliation(s)
- L H Olsen
- Department of Anatomy and Physiology, The Royal Veterinary and Agricultural University, 7 Groennegaardsvej, DK-1870, Frederiksberg C, Denmark
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Jensen PD, Jensen FT, Christensen T, Eiskjaer H, Baandrup U, Nielsen JL. Evaluation of myocardial iron by magnetic resonance imaging during iron chelation therapy with deferrioxamine: indication of close relation between myocardial iron content and chelatable iron pool. Blood 2003; 101:4632-9. [PMID: 12576333 DOI: 10.1182/blood-2002-09-2754] [Citation(s) in RCA: 130] [Impact Index Per Article: 6.2] [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: 12/17/2022] Open
Abstract
Evaluation of myocardial iron during iron chelation therapy is not feasible by repeated endomyocardial biopsies owing to the heterogeneity of iron distribution and the risk of complications. Recently, we described a noninvasive method based on magnetic resonance imaging. Here, the method was used for repeated estimation of the myocardial iron content during iron chelation with deferrioxamine in 14 adult nonthalassemic patients with transfusional iron overload. We investigated the repeatability of the method and the relationship between the myocardial iron estimates and iron status. The repeatability coefficient (2sD) was 2.8 micromol/g in the controls (day-to-day) and 4.0 micromol/g in the patients (within-day). Myocardial iron estimates were elevated in 10 of all 14 patients at first examination, but normalized in 6 patients after 6 to 18 months of treatment. If liver iron declined below 350 micromol/g all but one of the myocardial iron estimates were normal or nearly normal. At start (R2 = 0.69, P =.0014) and still after 6 months of iron chelation (R2 = 0.76, P =.001), the estimates were significantly and more closely related to the urinary iron excretion than to liver iron or serum ferritin levels. In conclusion, our preliminary data, which may only pertain to patients with acquired anemias, suggest the existence of a critical liver iron concentration, above which elevated myocardial iron is present, but its extent seems related to the size of the chelatable iron pool, as reflected by the urinary iron excretion. This further supports the concept of the labile iron pool as the compartment directly involved in transfusional iron toxicity.
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Affiliation(s)
- Peter D Jensen
- Department of Hematology, Aarhus University Hospital, Aarhus, Denmark.
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Abstract
Although enteroviruses have long been considered the most common cause of inflammatory heart muscle diseases, parvovirus B19 (PVB19) is emerging as a new and important candidate for myocarditis and dilated cardiomyopathy with inflammation (DCMi) and without inflammation (DCM). We investigated left ventricular endomyocardial biopsy specimens from 110 patients with suspected inflammatory heart disease for the presence of PVB19, Coxsackie virus (CVB), and adenovirus (Ad2) genome by polymerase chain reaction. Diagnosis of myocarditis (36 patients), DCM (18 patients), DCMi (13 patients), and perimyocarditis (12 patients) was made by immunohistochemical and histopathological investigation of endomyocardial biopsy specimens. A control group consisting of patients with arterial hypertension was also investigated. Prevalence of the PVB19 genome in endomyocardial biopsy specimens was highest in patients with DCMi (3 of 13) and patients with myocarditis (7 of 36); in patients with DCM and perimyocarditis, prevalence was 3 of 13 and 2 of 12, respectively. In patients with resolved myocarditis, no PVB19 DNA was detected; in patients with no inflammation and controls, prevalence was only 4% and 7%, respectively. CVB-RNA was detected in endomyocardial biopsy specimens from 3 of 37 patients with myocarditis; Ad2-DNA was found in 1 patient with DCM and 1 patient with perimyocarditis. These findings suggest an association of the PVB19 genome in endomyocardial biopsy specimens of adults with the development of DCM, DCMi, and chronic myocarditis more frequently than previously expected. PVB19 should therefore be recognized as a potential cardiotropic pathogen in patients of all ages.
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Affiliation(s)
- Sabine Pankuweit
- Department of Internal Medicine'Cardiology and Patholody, Philipps'University Marburg, Marburg, Germany
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Affiliation(s)
- Michael Schoppet
- Department of Internal Medicine and Cardiology, Philipps-University, Baldingerstrasse, Marburg, Germany.
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