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Jensen VF, Jensen NK, Schefe LH, Sigh J, Akintomide A, Kaaber K, Moesgaard SG, Pedersen MH. The Non-Human Primate in Safety Assessment of a Bifunctional Long-Acting Insulin Analogue. Int J Toxicol 2023; 42:254-268. [PMID: 36799227 DOI: 10.1177/10915818231156898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
Species selection plays a pivotal part during non-clinical safety assessment in drug development. If possible, use of non-human primates (NHPs) should be avoided due to ethical considerations. However, limiting factors as lack of pharmacologic activity in other species could necessitate use of NHPs. LAI-PCSK9i is a bi-functional molecule combining a long-acting insulin analogue with a PCSK9 inhibitor peptide aiming to provide glycaemic control and to reduce plasma LDL concentrations. The NHP was chosen for the safety assessment of LAI-PCSK9i being the most relevant species with basal levels and plasma lipid composition closest to humans, while the dog and initially also the minipig were deemed irrelevant due to lack of pharmacologic activity on LDL-lowering and biological differences in lipid profiles. An in vivo tolerability and toxicokinetic study of LAI-PCSK9i in NHPs showed recurrent and severe hypoglycaemia at very low doses. Therefore, the minipig was re-evaluated and a follow-up study thoroughly assessing blood glucose and cholesterol levels and clinical signs illustrated that minipigs dosed with LAI-PCSK9i, tolerated the compound and LAI-PCSK9i decreased glucose and LDL over time. This work underlines that careful consideration is required when selecting species during safety assessment in drug development. The tolerability issue in NHPs led to the subsequent selection of the minipig for safety evaluation of LAI-PCSK9i although as a suboptimal alternative, which unexpectedly had a measurable pharmacologic response on LDL lowering. In conclusion, the NHPs may be unsuitable as test species for safety assessment of long-acting insulin analogues due to high sensitivity to recurring hypoglycaemic episodes.
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Affiliation(s)
- Vivi Fh Jensen
- Global Drug Discovery and Development Sciences, 1450Novo Nordisk A/S, Maaloev, Denmark
| | - Nikolai K Jensen
- Global Drug Discovery and Development Sciences, 1450Novo Nordisk A/S, Maaloev, Denmark
| | - Line H Schefe
- Global Drug Discovery and Development Sciences, 1450Novo Nordisk A/S, Maaloev, Denmark
| | - Jens Sigh
- Global Drug Discovery and Development Sciences, 1450Novo Nordisk A/S, Maaloev, Denmark
| | | | | | | | - Mona H Pedersen
- Global Drug Discovery and Development Sciences, 1450Novo Nordisk A/S, Maaloev, Denmark
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Liljas AEM, Pulkki J, Jensen NK, Burström B, Keskimäki I, Andersen I, Jämsen E, Agerholm J. Professionals’ roles in the hospital discharge of older adults in 3 Nordic cities: a vignette study. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac130.109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
The hospital discharge process of older adults in need of both medical and social care post hospitalisation requires extensive care coordination. Cooperation and continuity between involved care providers are essential, however, existing care systems including the Nordic care systems, are poorly designed to provide health and social care to patients with complex health and social care needs which increases the risk of certain groups not receiving optimal care.
Aim and methods
This study aims to examine and compare what roles, responsibility and actions nurses take in the hospital discharge process of older adults with complex care needs in three Nordic cities: Copenhagen (Denmark), Stockholm (Sweden) and Tampere (Finland). A vignette study consisting of three fictive cases was conducted face-to-face with nurses in Copenhagen (n = 11), Stockholm (n = 16) and Tampere (n = 8). Participants were identified through the researchers’ networks and snowball sampling. The vignettes represent older patients with age-related medical conditions of which one also has cognitive loss and one looks after their partner with dementia. The cases further include differences in the home help received by their children, physical obstacles in their homes and unwillingness of becoming a burden to the system. A thematic approach is used for the data analysis.
Results and conclusions
Preliminary results suggest that the informants’ roles and engagement in the coordination and collaboration may differ both within and between the systems studied, and that they take responsibility beyond their job roles particularly if the patient has no close relatives. The study is of public health importance as it identifies gaps in how the care is organised in the three welfare states targeted. It also sheds light on the complexities of providing universal care in ageing societies where a growing proportion of older adults have both medical and social care needs.
Key messages
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Affiliation(s)
- AEM Liljas
- Global Public Health, Karolinska Institutet , Stockholm, Sweden
| | - J Pulkki
- Faculty of Social Sciences, Tampere University , Tampere, Finland
| | - NK Jensen
- Department of Public Health, Copenhagen University , Copenhagen, Denmark
| | - B Burström
- Global Public Health, Karolinska Institutet , Stockholm, Sweden
| | - I Keskimäki
- Faculty of Social Sciences, Tampere University , Tampere, Finland
| | - I Andersen
- Department of Public Health, Copenhagen University , Copenhagen, Denmark
| | - E Jämsen
- Faculty of Social Sciences, Tampere University , Tampere, Finland
| | - J Agerholm
- Global Public Health, Karolinska Institutet , Stockholm, Sweden
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Jensen NK, Ingvorsen C, Petersen DR, Pereira MJ, Lu TTH, Alsted TJ, Kirkegaard JS, Keane KA. Characterization of the Nonendocrine Cell Populations in Human Embryonic Stem Cell-Derived (hESC) Islet-Like Clusters Posttransplantation. Toxicol Pathol 2021; 49:1269-1287. [PMID: 34555946 DOI: 10.1177/01926233211036395] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Islet-like clusters derived from human embryonic stem cells (hESC) hold the potential to cure type 1 diabetes mellitus. Differentiation protocols of islet-like clusters lead to the generation of minor fractions of nonendocrine cells, which are mainly from endodermal and mesodermal lineages, and the risk of implanting these is unclear. In the present study, the histogenesis and the tumorigenicity of nonendocrine cells were investigated in vivo. Immunodeficient mice were implanted under the kidney capsule with islet-like clusters which were derived from differentiation of cells batches with either an intermediate or poor cell purity and followed for 8 or 26 weeks. Using immunohistochemistry and other techniques, it was found that the intermediate differentiated cell implants had limited numbers of small duct-like cysts and nonpancreatic tissue resembling gastrointestinal and retinal pigmented epithelium. In contrast, highly proliferative cystic teratomas were found at a high incidence at the implant site after 8 weeks, only in the animals implanted with the poorly differentiated cells. These findings indicate that the risk for teratoma formation and the amount of nonpancreatic tissue can be minimized by careful in-process characterization of the cells and thus highlights the importance of high purity at transplantation and a thorough ex-vivo characterization during cell product development.
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Affiliation(s)
- Nikolai K Jensen
- Toxicology Development Projects, GDDS, 1450Novo Nordisk A/S, Maaloev, Denmark
| | - Camilla Ingvorsen
- Stem Cell Imaging and Pharmacology, Stem Cell R&D, 1450Novo Nordisk A/S, Maaloev, Denmark
| | - Dorthe R Petersen
- Stem Cell Biology, Stem Cell R&D, 1450Novo Nordisk A/S, Maaloev, Denmark
| | - Maria J Pereira
- Stem Cell Imaging and Pharmacology, Stem Cell R&D, 1450Novo Nordisk A/S, Maaloev, Denmark
| | - Tess T H Lu
- Target Discovery, Ochre Bio Taiwan Ltd, Taipei City
| | - Thomas J Alsted
- Stem Cell Imaging and Pharmacology, Stem Cell R&D, 1450Novo Nordisk A/S, Maaloev, Denmark
| | | | - Kevin A Keane
- Stem Cell Imaging and Pharmacology, Stem Cell R&D, 1450Novo Nordisk A/S, Maaloev, Denmark
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Hvid H, Skydsgaard M, Jensen NK, Viuff BM, Jensen HE, Oleksiewicz MB, Kvist PH. Artificial Intelligence-Based Quantification of Epithelial Proliferation in Mammary Glands of Rats and Oviducts of Göttingen Minipigs. Toxicol Pathol 2020; 49:912-927. [PMID: 32840183 DOI: 10.1177/0192623320950633] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Quantitative assessment of proliferation can be an important endpoint in toxicologic pathology. Traditionally, cell proliferation is quantified by labor-intensive manual counting of positive and negative cells after immunohistochemical staining for proliferation markers (eg, Ki67, bromo-2'-deoxyuridine, or proliferating cell nuclear antigen). Currently, there is a lot of interest in replacing manual evaluation of histology end points with image analysis tools based on artificial intelligence. The aim of the present study was to explore if a commercially available image analysis software can be used to quantify epithelial proliferative activity in rat mammary gland and minipig oviduct. First, algorithms based on artificial intelligence were trained to detect epithelium in each tissue. Areas of BrdU- or Ki67-positive nuclei and negative nuclei were subsequently quantified with threshold analysis. Artificial intelligence-based and manually counted labelling indices were strongly correlated and equally well detected the estrous cycle influence on proliferation in mammary gland and oviduct epithelium, as well as the dramatically increased proliferation in rat mammary glands after treatment with estradiol and progesterone. In conclusion, quantification of epithelial proliferation in two reproductive tissues can be achieved in a reliable fashion using image analysis software based on artificial intelligence, thus avoiding time- and labor-intensive manual counting, requiring trained operators.
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Affiliation(s)
- Henning Hvid
- Pathology & Imaging, 1450Novo Nordisk A/S, Måløv, Denmark
| | | | | | | | - Henrik E Jensen
- Section of Pathology, University of Copenhagen, Kobenhavn, Denmark
| | | | - Peter H Kvist
- Pathology & Imaging, 1450Novo Nordisk A/S, Måløv, Denmark
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Jensen NK, McAllister A, Wadiwel D, Elliot A, Hwang G. Convergence in disability policies in the welfare states Denmark, Sweden, the UK and Australia? Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz186.703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
A state’s relation to citizens who are not able to support themselves due to illness is one of the cornerstones of welfare states. However, rising numbers of people on disability benefits is a challenge in many welfare states. The first aim is to investigate how policies around eligibility to disability benefits articulate a concept of ’incapacity to work’ across social democratic (Denmark and Sweden) and liberal welfare states (Australia and the UK). Secondly, we wish to explore how the conceptualisation of capacity and incapacity to work shapes prevailing constructions of disability.
Methods
In this study, we analyse official policy documents from governments, legislation, scientific and grey literature on disability benefit reforms in the selected countries. The analytical framework introduces the notion of decommodification of labour for people with disability and the ’social model of disability’ in relation to the constructions of disability in current disability benefit reforms.
Results (preliminary)
Restricting access to disability benefits has been a key feature of the recent reforms across all different types of welfare states. Liberal welfare states are more pervasive in reassessment of previously granted benefits compared to social democratic welfare states. The construction of disability in recent reforms is at odds with the social model of disability.
Conclusions (preliminary)
Across both liberal and social democratic welfare states eligibility for disability benefits is articulated around notions of incapacity to work. Retrenchment of benefits is, overall, most pervasive in liberal welfare states.
Key messages
The convergence in social policies across both social democratic and liberal welfare states speaks to the pervasiveness of neo-liberal notions in current social policy. The tightening of eligibility criteria for disability benefits poses great financial and health risks to people with illness struggling to support themselves.
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Affiliation(s)
- N K Jensen
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - A McAllister
- Disability and Health Unit, University of Melbourne, Melbourne, Australia
| | - D Wadiwel
- Department of Sociology and Social Policy, University of Sydney, Sydney, Australia
| | - A Elliot
- Department of Sociology and Social Policy, University of Sydney, Sydney, Australia
| | - G Hwang
- Department of Sociology and Social Policy, University of Sydney, Sydney, Australia
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Jensen NK, Thielen K, Andersen I, Brønnum-Hansen H, Burström B, Nylén L, McAllister A, Diderichsen F. Social inequality in functional limitations and workability for people with musculoskeletal pain. Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx186.208] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- NK Jensen
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - K Thielen
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - I Andersen
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - H Brønnum-Hansen
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - B Burström
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - L Nylén
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - A McAllister
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - F Diderichsen
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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Jensen NK, Johansen KS, Kastrup M, Krasnik A, Norredam M. Continuity of care in the psychiatric health care system - a patient persepctive of immigrants, refugees and ethnic Danes. Eur J Public Health 2013. [DOI: 10.1093/eurpub/ckt124.115] [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: 11/12/2022] Open
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Lassen MR, Borris LC, Anderson BS, Jensen HP, Skejø Bro HP, Andersen G, Petersen AO, Siem P, Hørlyck E, Jensen BV, Thomsen PB, Hansen BR, Erin-Madsen J, Møller JC, Rotwitt L, Christensen F, Nielsen JB, Jørgensen PS, Paaske B, Tørholm C, Hvidt P, Jensen NK, Nielsen AB, Appelquist E, Tjalve E. Efficacy and safety of prolonged thromboprophylaxis with a low molecular weight heparin (dalteparin) after total hip arthroplasty--the Danish Prolonged Prophylaxis (DaPP) Study. Thromb Res 1998; 89:281-7. [PMID: 9669750 DOI: 10.1016/s0049-3848(98)00018-8] [Citation(s) in RCA: 118] [Impact Index Per Article: 4.5] [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: 02/08/2023]
Abstract
The aim of this study was to compare the efficacy and safety of prolonged (35 days) thromboprophylaxis with a standard length (7 days) regimen of a low molecular weight heparin in patients undergoing total hip arthroplasty. The study was multicentre, randomised, double-blind, and prospective with two groups. Following seven days on a standard length regimen of dalteparin (5000 antifactor Xa units subcutaneously once daily starting 12 h before surgery), patients were randomized to continue the prophylaxis with either subcutaneous injections of dalteparin or placebo injections for a further 28 days. Efficacy was evaluated at the end of the study (day 35) in all patients with bilateral ascending phlebography to detect deep vein thrombosis. Bleeding complications and other adverse events were registered throughout the study period. Three hundred consecutive patients agreed to participate before the operation: 281 were finally randomised and 215 completed the study; two patients died before randomisation; 17 developed deep vein thrombosis; none developed pulmonary embolism; and five of 113 patients (4.4%, 95% CI 1-10%) developed deep vein thrombosis in the dalteparin group, compared with 12 of 102 (11.8%; 95% CI 6-20%) in the placebo group (p=0.039). Deep vein thrombosis in the proximal veins was diagnosed in one patient (0.9%; 95% CI 0-5%) in the dalteparin group, and in five (5.0%; 95% CI 2-11%) in the placebo group (p=0.076). Major bleeding was observed in one patient in the placebo group; minor bleeding complications and adverse events were equally distributed between the groups. We concluded that prolonged (35 days) thrombo prophylaxis with dalteparin is more effective than a standard length (7 days) regimen without increased risk of bleeding complications or other adverse events.
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Bjarnesen JP, Wester JU, Siemssen SS, Blomqvist G, Jensen NK. External tissue stretching for closing skin defects in 22 patients. Acta Orthop Scand 1996; 67:182-4. [PMID: 8623577 DOI: 10.3109/17453679608994668] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
In this prospective study, we treated 12 women and 10 men with a newly developed skin-stretching system. The stretching device was used for the closure of 9 fasciotomies and for preoperative skin extension before excision of 6 tattooes, 7 splitskin transplants, 4 giant naevi, and 3 scars. The stretching device was placed under the skin, using local anesthesia. The patient stretched the skin. The mean stretching time was 4 (2-11) days. 20 patients completed the expansion successfully, with no pain or only slight discomfort. In 2 cases, we observed minor complications during the expansion. The external skin-stretching system can be used to obtain primary closure of defects where splitskin transplants otherwise would be necessary. The method can be applied in out-patients, using local anesthesia.
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Affiliation(s)
- J P Bjarnesen
- Department of Plastic Surgery, Odense University Hospital, Denmark
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Abstract
The objective of the present study was to investigate whether the reliability of tenderness evaluation can be increased by using a new technique called "pressure-controlled palpation" (pcp). The technique has been made possible by a newly invented piece of equipment called a palpometer, with which a pressure-sensitive plastic film attached to the index finger records the pressure exerted. In 15 patients with chronic tension-type headache and in 15 healthy volunteers, 2 investigators studied myofascial tenderness using conventional palpation and pressure-controlled palpation. Tenderness was scored on a 4-point scale in each of the examined pericranial regions. The sum of tenderness scores recorded by two observers using conventional palpation differed significantly (p = 0.0003), while results did not differ between observers using pressure-controlled palpation (p = 0.89). During palpation with seven different pressure intensities a positive and linear relation between pressure and pain intensity was found (p = 0.00006). Pain intensity reported by the subjects correlated highly with tenderness scored by the observer (rs = 0.95, p < 0.0001). These results demonstrate for the first time that tenderness scores can be compared between observers if palpation pressure is controlled. Pressure-controlled palpation represents a major improvement on current palpation techniques and should be standard in future research on myofascial pain disorders.
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Affiliation(s)
- L Bendtsen
- Department of Neurology, Glostrup Hospital, University of Copenhagen, Denmark
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Lock-Andersen J, Hou-Jensen K, Hansen JP, Jensen NK, Søgaard H, Andersen PK. Observer variation in histological classification of cutaneous malignant melanoma. Scand J Plast Reconstr Surg Hand Surg 1995; 29:141-8. [PMID: 7569811 DOI: 10.3109/02844319509034330] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
To evaluate the variations within and between observers in the interpretation of important histological prognostic factors, a series of 96 melanoma patients was randomly selected from a database of 1691 patients with cutaneous malignant melanoma. The stained sections were examined on two occasions by four experienced pathologists. Analysis by observed agreement and kappa statistics showed maximal tumour thickness to be the best reproducible variable, with ulceration the second best. Regression was the least reproducible, with level of invasion and type of melanoma in the mid range. Intra-observer variation was uniformly less than inter-observer variation for each variable. For tumour thickness a variance component analysis was done to quantify the variability further. The clinician should not base his choice of treatment entirely on the microscopic classification but take into consideration the clinical course and appearance of the tumour.
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Affiliation(s)
- J Lock-Andersen
- Department of Plastic, National University Hospital, Rigshospitalet, Copenhagen, Denmark
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Jensen NK. [Continuing education. Custom-made guidance. Interview by Mette-Marie Davidsen]. Sygeplejersken 1993; 93:24-25. [PMID: 8059361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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Jensen NK. [Patient Complaint Tribunal. Use those plaintiffs. Interview by Kirsten Bjørnsson]. Sygeplejersken 1993; 93:7-8, 24. [PMID: 8009449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Abstract
We report a case of haemangiopericytoma occurring intra-articularly in the synovium of the knee joint. This is a rare tumour which, as far as is known to the authors, has not previously been described in a subsynovial site.
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Affiliation(s)
- C Ladefoged
- Institute of Pathology, Odense University Hospital, Denmark
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Beck HI, Brandrup F, Hagdrup HK, Jensen NK, Starklint H. Adult, acquired reactive perforating collagenosis. Report of a case including ultrastructural findings. J Cutan Pathol 1988; 15:124-8. [PMID: 3372790 DOI: 10.1111/j.1600-0560.1988.tb00532.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
A case of reactive perforating collagenosis in an adult male patient with chronic renal failure. Pruritic, umbilicate papules, showing extrusion of collagen fibers through the epidermis were detected histopathologically. Electron microscopy showed absence of basal membrane beneath the perforation and collagen fibers with preserved periodicity passing through widened intercellular spaces with islands of cytoplasmic material.
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Affiliation(s)
- H I Beck
- Department of Dermatology, Odense University Hospital, Denmark
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Hjortsø E, Qvist J, Bud MI, Thomsen JL, Andersen JB, Wiberg-Jørgensen F, Jensen NK, Jones R, Reid LM, Zapol WM. ARDS after accidental inhalation of zinc chloride smoke. Intensive Care Med 1988; 14:17-24. [PMID: 3278025 DOI: 10.1007/bf00254116] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Five soldiers were injured by inhalation of hexite smoke (ZnCl2) during military training. Two soldiers, not wearing gas masks breathed hexite for 1 or 2 min, they slowly developed severe adult respiratory distress syndrome (ARDS) over the ensuing 2 weeks. This slow, progressive clinical course has not been previously described. In both patients, an increased plasma zinc concentration was measured 3 weeks after the incident. Intravenous and nebulized acetylcysteine increased the urinary excretion of zinc, and briefly decreased the plasma levels. In an attempt to arrest collagen deposition in the lungs, L-3,4 dehydroproline was administered. Both patients died of severe respiratory failure (25 and 32 days after inhalation). At autopsy diffuse microvascular obliteration, widespread occlusion of the pulmonary arteries and extensive interstitial and intra-alveolar fibrosis was observed. Three soldiers wearing ill fitting gas masks, immediately developed severe coughing and dyspnea. They improved, and 12 months after exposure their lung function tests were nearly normal, but they still had slight dyspnea on exercise.
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Affiliation(s)
- E Hjortsø
- Department of Anesthesia, Herlev Hospital, University of Copenhagen, Faculty of Medicine, Denmark
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Hjortsø E, Bud JM, Thomsen JL, Jensen NK, Qvist J. [Zinc chloride poisoning. Observation and treatment]. Ugeskr Laeger 1987; 149:2381-4. [PMID: 3450044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Bekker C, Jensen NK. [Unexpected findings at autopsy. Can the clinical value of the autopsy be predicted?]. Ugeskr Laeger 1986; 148:3199-202. [PMID: 3810913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Abstract
Trisomy 20 mosaicism in cultured amniotic fluid cells has in only a few cases been confirmed in fetal tissue. This may lead to the assumption that the trisomic cells are of extra-fetal origin and interruption of the pregnancy is not advisable. Chromosome analysis of numerous fetal tissues indicated in two cases the presence of one or more trisomy 20 cell clones in rectum and esophagus, respectively. The clinical significance of trisomy 20 mosaicism in single organs remains to be elucidated. Besides the karyotype, genetic counselling should take into account all accessible information of the pregnancy, e.g. ultra-sound, serum alpha-fetoprotein values and obstetrical history.
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Jacobsen FK, Abildtrup N, Laursen SO, Brandrup F, Jensen NK. Acrokeratosis paraneoplastica (Bazex' syndrome). Arch Dermatol 1984; 120:502-4. [PMID: 6703754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
A 63-year-old man had acrokeratosis paraneoplastica (Bazex' syndrome) characterized by violaceous erythema and scaling of the fingers, toes, nose, and aural helices. Severe nail dystrophy was present. Extensive examination of the patient for malignant neoplasms a few months after the initial appearance of the skin changes disclosed no abnormalities, but one year after onset, an epidermoid carcinoma of the lung was found.
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Oster-Jørgensen E, Rønne M, Jensen NK, Grunnet N. Malignant histiocytosis. The diagnosis based on chromosomal, immunologic and histiopathologic analysis. Scand J Haematol 1983; 30:167-73. [PMID: 6601287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
A 38-year-old female suffered for several months from persistent fever without signs of infectious or immunologic disease. 57Co-bleomycin scintigraphy revealed abnormal concentration in the liver. Following a diagnostic laparotomy, the patient died from abdominal haemorrhage. Malignant cell infiltration was demonstrated in a biopsy from the liver. Histiocytic cells were demonstrated in a bone marrow smear obtained shortly before death. Investigation of cultured lymphocytes obtained from the patient the day before she died showed deficiency of T-lymphocytes. Investigations of chromosomes delineated several clones with polyploidi. The diagnosis of malignant histiocytosis was based on erythrophagocytosis, and immunologic and chromosomal aberrations. If malignant histiocytosis is the primary disease, a terminal stage of different diseases or a sign of complication secondary to immuno incompetence (e.g. virus infection) is an open question.
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Andersen KW, Mosbech J, Jensen NK. [Screening for cervix neoplasms in Fyn 1975-1977. Evaluation of a prevalence survey]. Ugeskr Laeger 1979; 141:3174-5. [PMID: 524497] [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: 12/15/2022]
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Schultz HP, Arends J, Brincker H, Engelholm SA, Genster H, Hansen HH, Isager K, Hou-Jensen K, Jensen NK, Jensen TS, Kock F, Lund F, von der Maase H, Pedersen BN, Olesen H, Pedersen M, Rygaard J, Sell A, Steenholdt S, Sveinsson T, Søgaard H, Słrensen BL, Walbom-Jłrgensen S. [The Danish Testis Cancer Project]. Ugeskr Laeger 1978; 140:2563-66. [PMID: 695106] [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: 12/24/2022]
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26
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Lynch MF, Jensen NK, Urdaneta L. Permanent cardiac pacemakers implanted in the pleural space. J Thorac Cardiovasc Surg 1978; 76:101-7. [PMID: 661358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Intrapleural implantation is recommended for children, active adolescents and adults, psychiatric patients, and infection-prone patients because of the protection afforded by the pleural space. The implantation technique is briefly described. Complications include diaphragmatic muscle stimulation (with a unipolar unit) and continuous migration of the pulse generator. The advantages of this implantation site include the following (1) reduced risk of lead fracture, (2) protection from physical trauma, (3) reduced risk of infection and erosion. (4) improved cosmetic appearance, and (5) minimized child/generator size disproportion. In one groups of patients undergoing both standard and intrapleural implantation, the number of pacing months per surgical procedure was increased from 5.1 months (standard implant) to 26.2 months (intrapleural implant). Intrapleural implantation may be considered the generator position of choice for the small percentage of patients who require special pacing system protection.
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Starklint H, Jensen NK, Thyro E. The extent of carcinoma in situ in urinary bladders with primary carcinomas. Acta Pathol Microbiol Scand A 1976; 84:130-6. [PMID: 1258641 DOI: 10.1111/j.1699-0463.1976.tb00082.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The occurrence of carcinoma in situ was examined in a consequtive series of cystectomy specimens from 43 patients. All patients were suffering from or had been suffering from primary bladder cancer. Carcinoma in situ was defined as a definitive polymorphia of enlarged nuclei with abnormal chromatin structure in non-tumour bearing areas. It was found in 26 bladders. By means of a systematic technique of cutting the specimens, the extent of the alterations was quantitied, relating the number of blocks containing the alteration to the total number of blocks in which the changes possibly might be present. The extent of carcinoma in situ ranged from 2 to 81% with an average of 20%. The distribution of the alterations was unpredictable, often strongly focal, most often in continuation of the tumour. In one specimen, the margins of resection were involved. The extent was largest in bladders with poorly differentiated tumours. A temporal relationship between in situ carcinoma and invasive carcinoma could not be shown, as regards tumour size and duration of clinical symptoms. The morphology of the changes is discussed seen in the light of variations in the normal epithelium lining the lower urinary tract. Minor degrees of atypia of the epithelium showed rather bad reproduction. The dominating occurrence of carcinoma in situ in bladders with poorly differentiated tumours may either be a manifestation of a biological difference between tumours of different grades of differentiation or that the morphological criteria used correspond to the in situ type of poorly differentiated tumours.
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Starklint H, KJAERGAARD J, Jensen NK. Types of metaplasia in forty urothelial bladder carcinomas. A systematic histological investigation. Acta Pathol Microbiol Scand A 1976; 84:137-42. [PMID: 1258642 DOI: 10.1111/j.1699-0463.1976.tb00083.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
In a systematic study of bladders from consecutively cystectomized patients, 40 primary urinary bladder carcinomas were examined with regard to the type of differentiation. Metaplastic areas were found in 24 of the tumours. A positive reaction of keratin to Kreybergs stain was required for the definition squamous metaplasia. Squamous areas were found in 16 of the tumours. In 4 tumours there was, in addition to squamos metaplasia, glandular metaplasia which was defined as definite glandular tissue with dysplasia of the epithelium. In 4 tumours, glandular metaplasia was also present in addition to the urothelial carcinoma. In 18 cases, metaplastic changes were present in the luminal portion of the tumour from which the biopsy material and desquaminated material originated. The occurrence of metaplasia was related to the degree of differentiation of the urothelial part of the tumour. Metaplastic changes were most frequent in the poorly differentiated tumours. The biopsies obtained pre-operatively permitted of the diagnosis metaplasia being made in 15 cases, while the cytological material suggested metaplastic changes in 4 cases only. The biological function of metaplasia is unknow. The possibility that these areas will react differently to radiation and chemotherapy is present and the frequency of such changes would suggest that their importance should be studied by their registration as mixed forms as stated by WHO.
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Brons M, Jensen NK, Kirkby B, Thybo E. [A 15 year period material of bladder cancer]. Ugeskr Laeger 1972; 134:1897-900. [PMID: 5074995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Pierach CA, Jensen NK, Schmidt WR, Garamiella JJ, Lynch MF, Bilgutay AM, Kelly WD. Surgical myocardial revascularization. A follow-up study. Minn Med 1971; 54:795-9. [PMID: 5112261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Pierach CA, Jensen NK. [Morphological findings after surgical revascularization of the heart]. Dtsch Med Wochenschr 1971; 96:746-8 passim. [PMID: 5552856 DOI: 10.1055/s-0028-1108323] [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: 01/15/2023]
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Garamella JJ, Jensen NK, Schmidt WR, Lynch MF, Bilgutay AM, Kelly WD, Pineda HG. Aortic coronary bypass. A review of 72 cases. Minn Med 1970; 53:1227-1232. [PMID: 5532559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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Sterns LP, Jensen NK, Schmidt WR, Garamella JJ, Lynch MF. Diaphragmatic disruption in major thoracic trauma: a review of 16 cases. Can J Surg 1969; 12:426-31. [PMID: 5352677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
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Bilgutay AM, Jensen NK, Schmidt WR, Garamella JJ, Lynch MF, Kelly WD. Mediastinoscopy. J Thorac Cardiovasc Surg 1969; 57:841-7. [PMID: 5770468] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Kovarik JL, Jensen NK. Congenital aplasia of the right hepatic lobe with right-sided diaphragmatic hernia and intestinal malrotation. Int Surg 1969; 51:499-503. [PMID: 5788660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
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Bilgutay AM, Jensen NK, Schmidt WR, Garamella JJ, Lynch MF, Kelly WD. Mediastinoscopy. Minn Med 1969; 52:585-90. [PMID: 5777020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Bilgutay AM, Jensen NK, Garamella JJ, Schmidt WR, Lynch MF. Incarceration of transvenous pacemaker electrode. Removal by traction. Minn Med 1968; 51:489-91. [PMID: 5641094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Bilgutay AM, Jensen NK, Garamella JJ, Schmidt WR, Lynch MF. Removal by traction of incarcerated transvenous pacemaker electrode. JAMA 1968; 203:154-5. [PMID: 5694070] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Lynch MF, Fuglestad EV, Jensen NK. The intrapleural roentgenogram. A forgotten tool for localizing a pulmonary foreign body. Am J Surg 1967; 113:516-9. [PMID: 6023027 DOI: 10.1016/0002-9610(67)90199-7] [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: 01/18/2023]
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Garamella JJ, Lynch JF, Jensen NK, Sterns LP, Schmidt WR. Extracranial internal carotid artery. Surgery for the occluded totally. Minn Med 1966; 49:1669-75. [PMID: 5979477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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Garamella JJ, Lynch MF, Jensen NK, Sterns LP, Schmidt WR. Endarterectomy and thrombectomy for the totally occluded extracranial internal carotid artery. Use of Fogarty balloon catheters. Ann Surg 1966; 164:325-33. [PMID: 5915942 PMCID: PMC1477232 DOI: 10.1097/00000658-196608000-00021] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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Jensen NK, Schmidt WR, Garamella JJ, Lynch MF, Peterson CA. Intracavitary cardiac pacing. JAMA 1966; 195:916-8. [PMID: 5951964] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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