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Jørgensen S, Have CT, Underwood CR, Johansen LD, Wellendorph P, Gjesing AP, Jørgensen CV, Quan S, Rui G, Inoue A, Linneberg A, Grarup N, Jun W, Pedersen O, Hansen T, Bräuner-Osborne H. Genetic Variations in the Human G Protein-coupled Receptor Class C, Group 6, Member A (GPRC6A) Control Cell Surface Expression and Function. J Biol Chem 2016; 292:1524-1534. [PMID: 27986810 DOI: 10.1074/jbc.m116.756577] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [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: 09/14/2016] [Revised: 12/14/2016] [Indexed: 12/30/2022] Open
Abstract
GPRC6A is a G protein-coupled receptor activated by l-amino acids, which, based on analyses of knock-out mice, has been suggested to have physiological functions in metabolism and testicular function. The human ortholog is, however, mostly retained intracellularly in contrast to the cell surface-expressed murine and goldfish orthologs. The latter orthologs are Gq-coupled and lead to intracellular accumulation of inositol phosphates and calcium release. In the present study we cloned the bonobo chimpanzee GPRC6A receptor, which is 99% identical to the human receptor, and show that it is cell surface-expressed and functional. By analyses of chimeric human/mouse and human/bonobo receptors, bonobo receptor mutants, and the single nucleotide polymorphism database at NCBI, we identify an insertion/deletion variation in the third intracellular loop responsible for the intracellular retention and lack of function of the human ortholog. Genetic analyses of the 1000 genome database and the Inter99 cohort of 6,000 Danes establish the distribution of genotypes among ethnic groups, showing that the cell surface-expressed and functional variant is much more prevalent in the African population than in European and Asian populations and that this variant is partly linked with a stop codon early in the receptor sequence (rs6907580, amino acid position 57). In conclusion, our data solve a more than decade-old question of why the cloned human GPRC6A receptor is not cell surface-expressed and functional and provide a genetic framework to study human phenotypic traits in large genome sequencing projects linked with physiological measurement and biomarkers.
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Affiliation(s)
- Stine Jørgensen
- From the Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, DK-2100 Copenhagen, Denmark
| | - Christian Theil Have
- the Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, DK-2200 Copenhagen, Denmark
| | - Christina Rye Underwood
- From the Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, DK-2100 Copenhagen, Denmark
| | - Lars Dan Johansen
- From the Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, DK-2100 Copenhagen, Denmark
| | - Petrine Wellendorph
- From the Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, DK-2100 Copenhagen, Denmark
| | - Anette Prior Gjesing
- the Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, DK-2200 Copenhagen, Denmark
| | - Christinna V Jørgensen
- From the Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, DK-2100 Copenhagen, Denmark
| | - Shi Quan
- BGI-Shenzhen, Shenzhen 518083, China
| | - Gao Rui
- BGI-Shenzhen, Shenzhen 518083, China
| | - Asuka Inoue
- the Laboratory of Molecular and Cellular Biochemistry, Graduate School of Pharmaceutical Sciences, Tohoku University, Sendai, Miyagi 980-8578, Japan.,the Japan Science and Technology Agency, Precursory Research for Embryonic Science and Technology, Kawaguchi, Saitama 332-0012, Japan
| | - Allan Linneberg
- the Research Centre for Prevention and Health, Capital Region of Denmark, DK-2600 Glostrup, Denmark.,the Department of Clinical Experimental Research, Rigshospitalet, DK-2100 Copenhagen, Denmark, and.,the Faculty of Health and Medical Sciences, University of Copenhagen, DK-2200 Copenhagen, Denmark
| | - Niels Grarup
- the Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, DK-2200 Copenhagen, Denmark
| | - Wang Jun
- BGI-Shenzhen, Shenzhen 518083, China
| | - Oluf Pedersen
- the Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, DK-2200 Copenhagen, Denmark
| | - Torben Hansen
- the Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, DK-2200 Copenhagen, Denmark
| | - Hans Bräuner-Osborne
- From the Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, DK-2100 Copenhagen, Denmark,
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Mor A, Antonsen S, Kahlert J, Holsteen V, Jørgensen S, Holm-Pedersen J, Sørensen HT, Pedersen O, Ehrenstein V. Prenatal exposure to systemic antibacterials and overweight and obesity in Danish schoolchildren: a prevalence study. Int J Obes (Lond) 2015; 39:1450-5. [PMID: 26178293 DOI: 10.1038/ijo.2015.129] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [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] [Received: 12/19/2014] [Revised: 06/26/2015] [Accepted: 07/04/2015] [Indexed: 12/16/2022]
Abstract
BACKGROUND/OBJECTIVE Prenatal exposure to antibacterials may permanently dysregulate fetal metabolic patterns via epigenetic pathways or by altering maternal microbiota. We examined the association of prenatal exposure to systemic antibacterials with overweight and obesity in schoolchildren. SUBJECTS/METHODS We conducted a prevalence study among Danish schoolchildren aged 7-16 years using data from routine school anthropometric evaluations conducted during 2002-2013. Prenatal exposure to antibacterials was ascertained by using maternal prescription dispensations and infection-related hospital admissions during pregnancy. We defined overweight and obesity among the children using standard age- and sex-specific cutoffs. We computed sex-specific adjusted prevalence ratios (aPRs) of overweight and obesity associated with exposure to prenatal antibacterials, adjusting for maternal age at delivery, marital status, smoking in pregnancy and multiple gestation; we also stratified the analyses by birth weight. RESULTS Among 9886 schoolchildren, 3280 (33%) had prenatal exposure to antibacterials. aPRs associated with the exposure were 1.26 (95% confidence interval (CI): 1.10-1.45) for overweight and 1.29 (95% CI: 1.03-1.62) for obesity. Among girls, aPRs were 1.16 (95% CI: 0.95-1.42) for overweight and 1.27 (95% CI: 0.89 to 1.82) for obesity. Among boys, aPRs were 1.37 (95% CI: 1.13-1.66) for overweight and 1.29 (95% CI: 0.96-1.73) for obesity. The aPR for overweight was higher among schoolchildren with birth weight <3500 g (aPR: 1.30, 95% CI: 1.05-1.61) than in schoolchildren with birth weight ⩾3500 g (aPR: 1.18, 95% CI: 0.95-1.46). Inversely, the association for obesity was higher among schoolchildren with birth weight ⩾3500 g (aPR: 1.35, 95% CI: 1.00-1.81) than among those who were <3500 g at birth (aPR: 1.16, 95% CI: 0.82-1.65). CONCLUSIONS Prenatal exposure to systemic antibacterials is associated with an increased risk of overweight and obesity at school age, and this association varies by birth weight.
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Affiliation(s)
- A Mor
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - S Antonsen
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - J Kahlert
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - V Holsteen
- Child and Adolescent Health Section, Department of Family and Employment, Municipality of Aalborg, Aalborg, Denmark
| | - S Jørgensen
- Child and Adolescent Health Section, Department of Family and Employment, Municipality of Aalborg, Aalborg, Denmark
| | - J Holm-Pedersen
- Child and Adolescent Health Section, Department of Family and Employment, Municipality of Aalborg, Aalborg, Denmark
| | - H T Sørensen
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - O Pedersen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - V Ehrenstein
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
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Olsen J, Kirkeby L, Olsen J, Eiholm S, Jørgensen S, Pedersen O, Jess P, Gogenur I, Troelsen J. P-190 Feasibility of using MicroRNAs in early detection of recurrence in colon cancer patients. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv233.188] [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: 11/13/2022] Open
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Nørskov-Lauritsen L, Jørgensen S, Bräuner-Osborne H. N-glycosylation and disulfide bonding affects GPRC6A receptor expression, function, and dimerization. FEBS Lett 2015; 589:588-97. [PMID: 25617829 DOI: 10.1016/j.febslet.2015.01.019] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Revised: 12/28/2014] [Accepted: 01/14/2015] [Indexed: 12/20/2022]
Abstract
Investigation of post-translational modifications of receptor proteins is important for our understanding of receptor pharmacology and disease physiology. However, our knowledge about post-translational modifications of class C G protein-coupled receptors and how these modifications regulate expression and function is very limited. Herein, we show that the nutrient-sensing class C G protein-coupled receptor GPRC6A carries seven N-glycans and that one of these sites modulates surface expression whereas mutation of another site affects receptor function. GPRC6A has been speculated to form covalently linked dimers through cysteine disulfide linkage in the extracellular amino-terminal domain and here we show that GPRC6A indeed is a homodimer and that a disulfide bridge between the C131 residues is formed.
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Affiliation(s)
- Lenea Nørskov-Lauritsen
- Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Stine Jørgensen
- Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Hans Bräuner-Osborne
- Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark.
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Strøbæk D, Brown DT, Jenkins DP, Chen YJ, Coleman N, Ando Y, Chiu P, Jørgensen S, Demnitz J, Wulff H, Christophersen P. NS6180, a new K(Ca) 3.1 channel inhibitor prevents T-cell activation and inflammation in a rat model of inflammatory bowel disease. Br J Pharmacol 2013; 168:432-44. [PMID: 22891655 DOI: 10.1111/j.1476-5381.2012.02143.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2012] [Revised: 06/21/2012] [Accepted: 08/07/2012] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND AND PURPOSE The K(Ca) 3.1 channel is a potential target for therapy of immune disease. We identified a compound from a new chemical class of K(Ca) 3.1 inhibitors and assessed in vitro and in vivo inhibition of immune responses. EXPERIMENTAL APPROACH We characterized the benzothiazinone NS6180 (4-[[3-(trifluoromethyl)phenyl]methyl]-2H-1,4-benzothiazin-3(4H)-one) with respect to potency and molecular site of action on K(Ca) 3.1 channels, selectivity towards other targets, effects on T-cell activation as well as pharmacokinetics and inflammation control in colitis induced by 2,4-dinitrobenzene sulfonic acid, a rat model of inflammatory bowel disease (IBD). KEY RESULTS NS6180 inhibited cloned human K(Ca) 3.1 channels (IC(50) = 9 nM) via T250 and V275, the same amino acid residues conferring sensitivity to triarylmethanes such as like TRAM-34. NS6180 inhibited endogenously expressed K(Ca) 3.1 channels in human, mouse and rat erythrocytes, with similar potencies (15-20 nM). NS6180 suppressed rat and mouse splenocyte proliferation at submicrolar concentrations and potently inhibited IL-2 and IFN-γ production, while exerting smaller effects on IL-4 and TNF-α and no effect on IL-17 production. Antibody staining showed K(Ca) 3.1 channels in healthy colon and strong up-regulation in association with infiltrating immune cells after induction of colitis. Despite poor plasma exposure, NS6180 (3 and 10 mg·kg(-1) b.i.d.) dampened colon inflammation and improved body weight gain as effectively as the standard IBD drug sulfasalazine (300 mg·kg(-1) q.d.). CONCLUSIONS AND IMPLICATIONS NS6180 represents a novel class of K(Ca) 3.1 channel inhibitors which inhibited experimental colitis, suggesting K(Ca) 3.1 channels as targets for pharmacological control of intestinal inflammation.
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Abstract
Maintenance of genomic integrity is essential to ensure normal organismal development and to prevent diseases such as cancer. Nuclear DNA is packaged into chromatin, and thus genome maintenance can be influenced by distinct chromatin environments. In particular, post-translational modifications of histones have emerged as key regulators of genomic integrity. Intense research during the past few years has revealed histone H4 lysine 20 methylation (H4K20me) as critically important for the biological processes that ensure genome integrity, such as DNA damage repair, DNA replication and chromatin compaction. The distinct H4K20 methylation states are mediated by SET8/PR-Set7 that catalyses monomethylation of H4K20, whereas SUV4-20H1 and SUV4-20H2 enzymes mediate further H4K20 methylation to H4K20me2 and H4K20me3. Disruption of these H4K20-specific histone methyltransferases leads to genomic instability, demonstrating the important functions of H4K20 methylation in genome maintenance. In this review, we explain molecular mechanisms underlying these defects and discuss novel ideas for furthering our understanding of genome maintenance in higher eukaryotes.
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Affiliation(s)
- Stine Jørgensen
- Biotech Research and Innovation Centre (BRIC), University of Copenhagen, Ole Maaløes Vej 5, 2200 Copenhagen N, Denmark
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Rask L, Balslev E, Jørgensen S, Eriksen J, Flyger H, Møller S, Høgdall E, Litman T, Nielsen BS. High expression of miR-21 in tumor stroma correlates with increased cancer cell proliferation in human breast cancer. APMIS 2011; 119:663-73. [PMID: 21917003 DOI: 10.1111/j.1600-0463.2011.02782.x] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Low-risk and high-risk breast cancer patients are stratified primarily according to their lymph node (LN) status and grading. However, some low-risk patients relapse, and some high-risk patients have a favorable clinical outcome, implying a need for better prognostic and predictive tests. Micro RNAs are often aberrantly expressed in cancer and microRNA-21 is upregulated in a variety of cancers, including breast cancer. High miR-21 levels have been associated with poor prognosis. To determine the cellular localization of miR-21 and to compare its expression levels with histopathological features, we performed in situ hybridization and semi-quantitative assessment of the miR-21 signal on 12 LN negative grade I (assumed low risk), and 12 LN positive grade II (high risk) breast cancers. miR-21 was predominantly seen in cancer associated fibroblast-like cells, with no difference in expression levels between grade I and grade II carcinomas. Immunohistochemical scoring of the prognostic proliferation marker Ki-67 and tumor suppressor p53 showed that the miR-21 expression levels significantly correlated with the Ki-67 score (p = 0.043), whereas no correlation between p53 and miR-21 was found. Our results indicate that miR-21 may contribute to improve clinical stratification according to growth rate and facilitate tailored treatment of breast cancer patients.
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Affiliation(s)
- Lene Rask
- Department of Oncology, Herlev Hospital, University of Copenhagen, Denmark.
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Jørgensen S, Eskildsen M, Fugger K, Hansen L, Larsen MSY, Kousholt AN, Syljuåsen RG, Trelle MB, Jensen ON, Helin K, Sørensen CS. SET8 is degraded via PCNA-coupled CRL4(CDT2) ubiquitylation in S phase and after UV irradiation. ACTA ACUST UNITED AC 2011; 192:43-54. [PMID: 21220508 PMCID: PMC3019552 DOI: 10.1083/jcb.201009076] [Citation(s) in RCA: 92] [Impact Index Per Article: 7.1] [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: 11/22/2022]
Abstract
Degradation of the histone H4 methyltransferase SET8, which regulates chromosome compaction and genomic integrity, is regulated by the CRL4(CDT2) ubiquitin ligase to facilitate DNA replication and repair. The eukaryotic cell cycle is regulated by multiple ubiquitin-mediated events, such as the timely destruction of cyclins and replication licensing factors. The histone H4 methyltransferase SET8 (Pr-Set7) is required for chromosome compaction in mitosis and for maintenance of genome integrity. In this study, we show that SET8 is targeted for degradation during S phase by the CRL4(CDT2) ubiquitin ligase in a proliferating cell nuclear antigen (PCNA)–dependent manner. SET8 degradation requires a conserved degron responsible for its interaction with PCNA and recruitment to chromatin where ubiquitylation occurs. Efficient degradation of SET8 at the onset of S phase is required for the regulation of chromatin compaction status and cell cycle progression. Moreover, the turnover of SET8 is accelerated after ultraviolet irradiation dependent on the CRL4(CDT2) ubiquitin ligase and PCNA. Removal of SET8 supports the modulation of chromatin structure after DNA damage. These results demonstrate a novel regulatory mechanism, linking for the first time the ubiquitin–proteasome system with rapid degradation of a histone methyltransferase to control cell proliferation.
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Affiliation(s)
- Stine Jørgensen
- Biotech Research and Innovation Centre, University of Copenhagen, Copenhagen, Denmark
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Jørgensen S, Baker A, Møller S, Nielsen BS. Robust one-day in situ hybridization protocol for detection of microRNAs in paraffin samples using LNA probes. Methods 2010; 52:375-81. [PMID: 20621190 DOI: 10.1016/j.ymeth.2010.07.002] [Citation(s) in RCA: 141] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2010] [Accepted: 07/04/2010] [Indexed: 12/21/2022] Open
Abstract
MicroRNAs (miRNAs) constitute a group of small non-coding RNA molecules generally 18-22 base-pairs in length. miRNAs are considered to be negative regulators of gene expression at the level of post-transcription and are important in normal physiological development, tissue homeostasis and disease. The cellular origin of individual microRNAs is of utmost importance for understanding their roles in molecular and biological processes, in multi-cellular and complex structured tissues. For the localization of miRNAs in clinical and experimental formalin-fixed and paraffin-embedded samples we have developed a simple and robust one-day in situ hybridization protocol based on the use of double digoxigenin (DIG)-labeled LNA-DNA chimeric probes. We show that the protocol enables analyses of specificity, and demonstrate the detection of miR-1, miR-21, miR-124, miR-126, miR-145, and miR-205 in human and murine paraffin material. The well established localization of these microRNAs makes them ideal for use as reference microRNAs when optimizing the microRNA in situ hybridization assay for a particular tissue and miRNA.
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Affiliation(s)
- Stine Jørgensen
- Exiqon A/S, Diagnostic Product Development, Skelstedet 16, Vedbæk, Denmark
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Høiby PE, Søkilde R, Friis G, Jørgensen S, Litman T. 29A microRNA expression profiling study of matching fresh frozen and formalin-fixed paraffin-embedded samples. APMIS 2008. [DOI: 10.1111/j.1600-0463.2008.001165_38.x] [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: 11/29/2022]
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Høiby PE, Søkilde R, Friis G, Jørgensen S, Litman T. 29 A microRNA expression profiling study of matching fresh frozen and formalin-fixed paraffin-embedded samples. APMIS 2008. [DOI: 10.1111/j.1600-0463.2008.00abs1165_38.x] [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: 11/28/2022]
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Jørgensen S, Elvers I, Trelle MB, Menzel T, Eskildsen M, Jensen ON, Helleday T, Helin K, Sørensen CS. The histone methyltransferase SET8 is required for S-phase progression. ACTA ACUST UNITED AC 2008; 179:1337-45. [PMID: 18166648 PMCID: PMC2373509 DOI: 10.1083/jcb.200706150] [Citation(s) in RCA: 187] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Chromatin structure and function is influenced by histone posttranslational modifications. SET8 (also known as PR-Set7 and SETD8) is a histone methyltransferase that monomethylates histonfe H4-K20. However, a function for SET8 in mammalian cell proliferation has not been determined. We show that small interfering RNA inhibition of SET8 expression leads to decreased cell proliferation and accumulation of cells in S phase. This is accompanied by DNA double-strand break (DSB) induction and recruitment of the DNA repair proteins replication protein A, Rad51, and 53BP1 to damaged regions. SET8 depletion causes DNA damage specifically during replication, which induces a Chk1-mediated S-phase checkpoint. Furthermore, we find that SET8 interacts with proliferating cell nuclear antigen through a conserved motif, and SET8 is required for DNA replication fork progression. Finally, codepletion of Rad51, an important homologous recombination repair protein, abrogates the DNA damage after SET8 depletion. Overall, we show that SET8 is essential for genomic stability in mammalian cells and that decreased expression of SET8 results in DNA damage and Chk1-dependent S-phase arrest.
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Affiliation(s)
- Stine Jørgensen
- Biotech Research and Innovation Centre and 2Centre for Epigenetics, University of Copenhagen, 2200 Copenhagen N, Denmark
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Diplas S, Knutsen T, Jørgensen S, Gunnæs AE, Våland T, Norby T, Olsen A, Taftø J. An experimental study of the electronic structure of anodically grown films on an amorphous Ni78Si8B14 alloy. SURF INTERFACE ANAL 2008. [DOI: 10.1002/sia.2748] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Hougaard C, Eriksen BL, Jørgensen S, Johansen TH, Dyhring T, Madsen LS, Strøbæk D, Christophersen P. Selective positive modulation of the SK3 and SK2 subtypes of small conductance Ca2+-activated K+ channels. Br J Pharmacol 2007; 151:655-65. [PMID: 17486140 PMCID: PMC2014002 DOI: 10.1038/sj.bjp.0707281] [Citation(s) in RCA: 122] [Impact Index Per Article: 7.2] [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: 11/09/2022] Open
Abstract
BACKGROUND AND PURPOSE Positive modulators of small conductance Ca(2+)-activated K(+) channels (SK1, SK2, and SK3) exert hyperpolarizing effects that influence the activity of excitable and non-excitable cells. The prototype compound 1-EBIO or the more potent compound NS309, do not distinguish between the SK subtypes and they also activate the related intermediate conductance Ca(2+)-activated K(+) channel (IK). This paper demonstrates, for the first time, subtype-selective positive modulation of SK channels. EXPERIMENTAL APPROACH Using patch clamp and fluorescence techniques we studied the effect of the compound cyclohexyl-[2-(3,5-dimethyl-pyrazol-1-yl)-6-methyl-pyrimidin-4-yl]-amine (CyPPA) on recombinant hSK1-3 and hIK channels expressed in HEK293 cells. CyPPA was also tested on SK3 and IK channels endogenously expressed in TE671 and HeLa cells. KEY RESULTS CyPPA was found to be a positive modulator of hSK3 (EC(50) = 5.6 +/- 1.6 microM, efficacy 90 +/- 1.8 %) and hSK2 (EC(50) = 14 +/- 4 microM, efficacy 71 +/- 1.8 %) when measured in inside-out patch clamp experiments. CyPPA was inactive on both hSK1 and hIK channels. At hSK3 channels, CyPPA induced a concentration-dependent increase in the apparent Ca(2+)-sensitivity of channel activation, changing the EC(50)(Ca(2+)) from 429 nM to 59 nM. CONCLUSIONS AND IMPLICATIONS As a pharmacological tool, CyPPA may be used in parallel with the IK/SK openers 1-EBIO and NS309 to distinguish SK3/SK2- from SK1/IK-mediated pharmacological responses. This is important for the SK2 and SK1 subtypes, since they have overlapping expression patterns in the neocortical and hippocampal regions, and for SK3 and IK channels, since they co-express in certain peripheral tissues.
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Affiliation(s)
- C Hougaard
- NeuroSearch A/S, Pederstrupvej 93 Ballerup, Denmark
| | - B L Eriksen
- NeuroSearch A/S, Pederstrupvej 93 Ballerup, Denmark
| | - S Jørgensen
- NeuroSearch A/S, Pederstrupvej 93 Ballerup, Denmark
| | - T H Johansen
- NeuroSearch A/S, Pederstrupvej 93 Ballerup, Denmark
| | - T Dyhring
- NeuroSearch A/S, Pederstrupvej 93 Ballerup, Denmark
| | - L S Madsen
- NeuroSearch A/S, Pederstrupvej 93 Ballerup, Denmark
| | - D Strøbæk
- NeuroSearch A/S, Pederstrupvej 93 Ballerup, Denmark
| | - P Christophersen
- NeuroSearch A/S, Pederstrupvej 93 Ballerup, Denmark
- Author for correspondence:
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Larsen L, Tonnesen M, Ronn SG, Størling J, Jørgensen S, Mascagni P, Dinarello CA, Billestrup N, Mandrup-Poulsen T. Inhibition of histone deacetylases prevents cytokine-induced toxicity in beta cells. Diabetologia 2007; 50:779-89. [PMID: 17265033 DOI: 10.1007/s00125-006-0562-3] [Citation(s) in RCA: 90] [Impact Index Per Article: 5.3] [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] [Received: 06/08/2006] [Accepted: 10/30/2006] [Indexed: 01/24/2023]
Abstract
AIMS/HYPOTHESIS The immune-mediated elimination of pancreatic beta cells in type 1 diabetes involves release of cytotoxic cytokines such as IL-1beta and IFNgamma, which induce beta cell death in vitro by mechanisms that are both dependent and independent of nitric oxide (NO). Nuclear factor kappa B (NFkappaB) is a critical signalling molecule in inflammation and is required for expression of the gene encoding inducible NO synthase (iNOS) and of pro-apoptotic genes. NFkappaB has recently been shown to associate with chromatin-modifying enzymes histone acetyltransferases and histone deacetylases (HDAC), and positive effects of HDAC inhibition have been obtained in several inflammatory diseases. Thus, the aim of this study was to investigate whether HDAC inhibition protects beta cells against cytokine-induced toxicity. MATERIALS AND METHODS The beta cell line, INS-1, or intact rat islets were precultured with HDAC inhibitors suberoylanilide hydroxamic acid or trichostatin A in the absence or presence of IL-1beta and IFNgamma. Effects on insulin secretion and NO formation were measured by ELISA and Griess reagent, respectively. iNOS levels and NFkappaB activity were measured by immunoblotting and by immunoblotting combined with electrophoretic mobility shift assay, respectively. Viability was analysed by 3-(4,5-dimethyldiazol-2-yl)-2,5-diphenyl-tetrazolium bromide and apoptosis by terminal deoxynucleotidyl transferase mediated dUTP nick end labeling (TUNEL) assay and histone-DNA complex ELISA. RESULTS HDAC inhibition reduced cytokine-mediated decrease in insulin secretion and increase in iNOS levels, NO formation and apoptosis. IL-1beta induced a bi-phasic phosphorylation of inhibitor protein kappa Balpha (IkappaBalpha) with the 2nd peak being sensitive to HDAC inhibition. No effect was seen on IkappaBalpha degradation and NFkappaB DNA binding. CONCLUSIONS/INTERPRETATION HDAC inhibition prevents cytokine-induced beta cell apoptosis and impaired beta cell function associated with a downregulation of NFkappaB transactivating activity.
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Affiliation(s)
- L Larsen
- Steno Diabetes Center, 2 Niels Steensens Vej, 2820, Gentofte, Denmark
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17
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Diplas S, Lehrmann J, Jørgensen S, Våland T, Watts JF, Taftø J. Characterization of NiB amorphous alloys with x-ray photoelectron and secondary ion mass spectroscopy. SURF INTERFACE ANAL 2005. [DOI: 10.1002/sia.2033] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Jørgensen S, Mauricio R. Neutral genetic variation among wild North American populations of the weedy plant Arabidopsis thaliana is not geographically structured. Mol Ecol 2004; 13:3403-13. [PMID: 15487999 DOI: 10.1111/j.1365-294x.2004.02329.x] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
We investigated neutral genetic variation within and among 53 wild-collected populations of the weedy annual plant, Arabidopsis thaliana, in North America, using amplified fragment length polymorphism (AFLP) markers. A. thaliana is thought to have been introduced to North America from Eurasia by humans; such an introduction might be expected to leave a clear geographical signal in the genetic data. To detect such patterns, we sampled populations at several hierarchical geographical levels. We collected individuals from populations in two areas of the Southeast and one in the Midwest, as well as individuals from populations in the Pacific Northwest and Northeast. To estimate within-population variation, we sampled eight individuals from each of six populations in the Southeast and Midwest. Among all 95 individuals analysed, we detected 131 polymorphic AFLP fragments. We found no evidence for continental or regional diversification. Individuals sampled from Midwestern and Southeastern populations intermingled in a neighbour-joining tree, and Mantel tests conducted within the Midwestern and Southeastern regions as well as the full data set failed to detect any significant relationship between geographical and genetic distance. These results mirror those found for most global surveys of neutral genetic variability in A. thaliana. Surprisingly, we detected substantial amounts of neutral genetic variability within populations. The levels of genetic variation within populations, coupled with the nongeographical nature of divergence among populations, are consistent with contemporary gene flow and point to a complex and dynamic population history of A. thaliana in North America.
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Affiliation(s)
- S Jørgensen
- Department of Genetics, Davison Life Sciences Complex, University of Georgia, Athens, GA 30602-7223, USA
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Craynest M, Jørgensen S, Sarvas M, Kontinen VP. Enhanced secretion of heterologous cyclodextrin glycosyltransferase by a mutant of Bacillus licheniformis defective in the D-alanylation of teichoic acids. Lett Appl Microbiol 2003; 37:75-80. [PMID: 12803561 DOI: 10.1046/j.1472-765x.2003.01357.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
AIMS To examine whether inactivation of the dlt operon and increased charge density of the wall enhances secretion of heterologous proteins in industrial strains of Bacillus licheniformis. METHODS AND RESULTS The dltA gene of B. licheniformis was cloned, sequenced and mutated by inserting a chloramphenicol acetyl transferase (cat) gene cassette. The mutation facilitated growth in the late exponential growth phase, increased endogenous autolysis and decreased resistance to a cationic peptide, polylysine. It was observed that dltA mutation increased the production of cyclodextrin glycosyltransferase (CGTase) by 1.5- to sevenfold depending on the growth phase, but decreased the production of penicillinase by twofold. CONCLUSIONS AND SIGNIFICANCE The results suggest that the d-alanylation of teichoic acids is an element that can be used to improve the production of some secretory proteins in industrial applications based on this important industrial microorganism.
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Affiliation(s)
- M Craynest
- Vaccine Development Laboratory, National Public Health Institute, Helsinki, Finland
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21
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Abstract
BACKGROUND The prognostic importance of dyskinesia after acute myocardial infarction is unknown, and recommendations have been made that dyskinesia be included in calculations of wall motion index (WMI). OBJECTIVE To determine whether it is necessary to distinguish between dyskinesia and akinesia when WMI is estimated for prognostic purposes following acute myocardial infarction. DESIGN Multicentre prospective study. PATIENTS 6676 consecutive patients, screened one to six days after acute myocardial infarction in 27 Danish hospitals. INTERVENTIONS WMI was measured in 6232 patients, applying the nine segment model, scoring 3 for hyperkinesia, 2 for normokinesia, 1 for hypokinesia, 0 for akinesia, and -1 for dyskinesia. Calculation of WMI either included information on dyskinesia or excluded this information by giving dyskinesia the same score as akinesia. MAIN OUTCOME MEASURES Long term outcome (up to seven years) with respect to mortality. RESULTS Dyskinesia occurred in 673 patients (10.8%). In multivariate analysis, WMI was an important prognostic factor, with a relative risk of 2.4 (95% confidence interval (CI), 2.2 to 2.7), while dyskinesia had no independent long term prognostic importance (relative risk 1.00; 95% CI, 0.89 to 1.12). For 30 day mortality dyskinesia had a relative risk of 1.23 (95% CI, 1.00 to 1.53) (p = 0.045). CONCLUSIONS Echocardiographic evaluation of left ventricular systolic function shortly after an acute myocardial infarct gives important prognostic information, but the presence of dyskinesia only has prognostic importance for the first 30 days.
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Affiliation(s)
- E Kjøller
- Section of Cardiology E 105, Medical Department E, Herlev University Hospital, Herlev, Denmark.
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22
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Jørgensen S. [The imposition of hands]. Dan Medicinhist Arbog 2001:199-212. [PMID: 11625131] [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: 02/21/2023]
Abstract
Details of the laying on of hands can be found in The Old Testament. Here there are accounts of diseases being cured and evil spirits being exorcised by the laying of hands. In the account of the Flood, approx. 3000 B.C. in the ancient Babylonic writings of Gilgames the Bablonian Utu-nipishtim and his wife were blessed after having saved their lives in the ark during the Flood. They were blessed by the Gods nestor Entil and consequently got divine powers for the rest of their lives. Anointing oil and the laying on of hands were known in Israel from Abrahams time approx. 1900 B.C. The New Testament tells of many cases of laying on of hands and healing of body and mind diseases by Jesus and his disciples. The method of healing by touch and anointing was continued by the High Priests and Kings who benefited by the fact that the people believed they could transfer their divine healing powers. The tradition continues through the Middle Ages to recent times through the French and English Kings to about 1830 and 1680 respectively. The medical use of touching a patient to diagnose seems to have lost ground with the possibilities which has developed since the discovery of the X-ray 100 years ago. SPECT: Single Photon Emission Tomography and PET: Positron Emission Tomography. The clinical use of laying on of hands has got a new perspective with the discovery and development of the bidigital O-ring test which can be used without the use of high technology. As yet there is little scientific acceptance of the value of this method of diagnosis.
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Kjøller K, Hölmich LR, Jacobsen PH, Friis S, Fryzek J, McLaughlin JK, Lipworth L, Henriksen TF, Jørgensen S, Bittmann S, Olsen JH. Capsular contracture after cosmetic breast implant surgery in Denmark. Ann Plast Surg 2001; 47:359-66. [PMID: 11601569 DOI: 10.1097/00000637-200110000-00001] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.6] [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: 11/25/2022]
Abstract
The authors investigated the association between the occurrence of capsular contracture and implant and patient characteristics. All women with breast implants from 1977 to 1997 were identified from the files of two private plastic surgery clinics in Denmark. Information on implant and patient characteristics, surgical procedure, and complications was obtained through medical records and self-administered questionnaires. Of 754 women (1,572 implants), average age at implantation was 32 years. Implant types were silicone double lumen, textured, 31.2%; silicone single lumen, textured, 27.8%; silicone single lumen, smooth, 24.5%; silicone double lumen, smooth, 0.8%; and other or missing, 15.7%. Placement was submuscular for more than 90% of implants. Capsular contracture occurred in 7.9% of implanted breasts, on an average of 621 days postoperatively, with 51.6% being bilateral. Overall, 66.1% of capsular contractures were recorded within the first 12 months postoperatively, and 79.0% were recorded within 24 months. Double-lumen implants were associated with a significantly (p < 0.01) reduced occurrence of capsular contracture. In summary, capsular contracture typically occurs within the first 2 years of implantation. Host factors may be important because more than half the capsular contractures in the current study were bilateral. Occurrence of capsular contracture did not appear to be associated with implant surface or placement, occurrence of local complications, or patient characteristics, although these findings should be interpreted cautiously.
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Affiliation(s)
- K Kjøller
- Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen
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Lundgren S, Jørgensen S, Kåresen R. [Breast cancer surgery in Norway 1990-95 illustrated by data from SINTEF United]. Tidsskr Nor Laegeforen 2001; 121:2688-93. [PMID: 11699375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023] Open
Abstract
BACKGROUND Breast-conserving therapy has been shown to be as effective as mastectomy in many cases; hence in many countries more breast cancer patients are offered this type of treatment. This study focuses on the amount and type of surgery used in Norway for breast cancer patients and the possible use of hospital discharge data to evaluate the diffusion of this surgical practice. MATERIAL AND METHODS Data from the nationwide Register of Hospital Discharges in Norway at SINTEF Unimed for patients operated for breast cancer from 1990 to 1995 were used. RESULTS 11,041 patients were registered with 11,727 hospital admissions for breast cancer operations from a total of 64 hospitals. The discrepancy in the number of breast cancer patients with the National Cancer Registry was 7%. Breast-conserving surgery was performed in 19.7%. An increase from 17% in 1990 to 21% in 1995 was found, but with variations according to type of hospital, county and age of patients. INTERPRETATION The percentage of breast conserving surgery is still low in Norway; this indicates that many women are not offered this type of surgery. With some caution, the data from SINTEF Unimed can be used to reflect the clinical practice over time at Norwegian hospitals. Further improvements could be obtained if national identity numbers were added to the database.
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Affiliation(s)
- J Nordling
- Urological Laboratory, Department of Urology H, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark
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Ottesen MM, Køber L, Jørgensen S, Torp-Pedersen C. Consequences of overutilization and underutilization of thrombolytic therapy in clinical practice. TRACE Study Group. TRAndolapril Cardiac Evaluation. J Am Coll Cardiol 2001; 37:1581-7. [PMID: 11345368 DOI: 10.1016/s0735-1097(01)01198-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate the consequences, measured as mortality and in-hospital stroke, of the use of thrombolytic therapy among patients with acute myocardial infarction (AMI), who do not fulfill accepted criteria or who have contraindications to thrombolytic therapy (i.e., overutilization) and among patients who are withheld thrombolytic treatment despite fulfilling indications and having no contraindications (i.e., underutilization). BACKGROUND The implementation of treatment with thrombolysis in clinical practice is not in accordance with the accepted criteria from randomized studies. The consequence has been over- and underutilization of thrombolytic therapy among patients with AMI in clinical practice. The outcome of overutilization of thrombolytic therapy has not been described previously. METHODS We examined 6,676 consecutive patients admitted to the hospital with an AMI and recorded characteristics, in-hospital complications and long-term mortality. RESULTS Overall, 41% of the patients received thrombolytic therapy. Thrombolytic therapy was underutilized in 14.3% and overutilized in 12.9% of the patients. The use of thrombolytic therapy was associated with reduced mortality in every subgroup examined, including patients without an accepted indication, with an accepted indication and in patients with prior stroke. The risk ratio of in-hospital stroke was not increased in connection with thrombolytic therapy, not even in patients with prior stroke (relative risk = 0.237, 95% confidence interval: 0.031 to 1.810, p = 0.17). CONCLUSIONS With the large benefit known to be associated with thrombolytic therapy and the favorable result of thrombolytic therapy in patients with contraindications observed in this study, we conclude that a formal evaluation of thrombolytic therapy in wider patient categories is warranted.
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Affiliation(s)
- M M Ottesen
- Department of Cardiology, Gentofte University Hospital of Copenhagen, Denmark.
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Pedersen AB, Kjøller E, Jørgensen S, Køber L, Ottesen M, Torp-Pedersen C. Serum uric acid as a prognostic marker in patients with acute myocardial infarction and left ventricular dysfunction. Eur J Heart Fail 2000. [DOI: 10.1016/s1388-9842(00)80225-1] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Affiliation(s)
| | - E. Kjøller
- Cardiology Clinic Amager Hospital; Copenhagen Denmark
| | - S. Jørgensen
- Cardiology Clinic Amager Hospital; Copenhagen Denmark
| | - L. Køber
- Dep. of Cardiology; Gentofte University Hospital; Copenhagen Denmark
| | - M. Ottesen
- Dep. of Cardiology; Gentofte University Hospital; Copenhagen Denmark
| | - C. Torp-Pedersen
- Dep. of Cardiology; Gentofte University Hospital; Copenhagen Denmark
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Reiche T, Lisby G, Jørgensen S, Christensen AB, Nordling J. A prospective, controlled, randomized study of the effect of a slow-release silver device on the frequency of urinary tract infection in newly catheterized patients. BJU Int 2000; 85:54-9. [PMID: 10619946 DOI: 10.1046/j.1464-410x.2000.00408.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To test the effect on urinary tract infections (UTIs) in patients needing continuous indwelling catheterization, of a newly designed urine-collecting system containing an antibacterial device which slowly releases silver ions onto the inner surface of the system. PATIENTS AND METHODS The study comprised a prospective controlled randomized trial; 213 patients fulfilled the inclusion criteria. They were randomized to a urine drainage system (comprising a Unometer 400 metering system or PP 2000N closed urine-bag system, both from Maersk Medical, Denmark) either with or without the antibacterial device. The efficacy was assessed as the number of UTIs and the time to infection in the 170 patients eligible for analysis. RESULTS There were fewer UTIs in those using the system containing the antibacterial device (19% vs 24%), but the difference was not statistically significant (P < 0.05). CONCLUSION The potential importance of different infection routes were highlighted, suggesting that modifications to Foley catheters and urine-collecting systems attempting to prevent UTIs should focus not only on the intraluminal pathway, but on the internal and external pathways of infection.
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Affiliation(s)
- T Reiche
- Maersk Medical A/S, Lynge, Denmark
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29
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Ottesen MM, Jørgensen S, Kjøller E, Videbaek J, Køber L, Torp-Pedersen C. Age-distribution, risk factors and mortality in smokers and non-smokers with acute myocardial infarction: a review. TRACE study group. Danish Trandolapril Cardiac Evaluation. J Cardiovasc Risk 1999; 6:307-9. [PMID: 10534133 DOI: 10.1177/204748739900600506] [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] [Indexed: 11/16/2022]
Abstract
Smoking is a risk factor for acute myocardial infarction; paradoxically, many studies have shown a lower post-infarct mortality among smokers. There are some important differences between smokers and non-smokers, which might explain the observed difference in mortality: smokers have less multivessel disease and atherosclerosis but are more thrombogenic; thrombolytic therapy seems to be more effective among smokers; smoking might result in an increased out-of-hospital mortality rate, by being more arrhythmogenic; and smokers are on average a decade younger than non-smokers at the time of infarction, and have less concomitant disease. Adjusting for these differences in regression analyses shows that smoking is not an independent risk factor for mortality after acute myocardial infarction. The difference in age and risk factors are responsible for the lower mortality among smokers.
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Affiliation(s)
- M M Ottesen
- Department of Cardiology P, Gentofte University Hospital of Copenhagen, Denmark.
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Olesen M, Gudmand-Høyer E, Holst JJ, Jørgensen S. Importance of colonic bacterial fermentation in short bowel patients: small intestinal malabsorption of easily digestible carbohydrate. Dig Dis Sci 1999; 44:1914-23. [PMID: 10505735 DOI: 10.1023/a:1018819428678] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
The small intestine's large capacity for glucose absorption and for adaptation seems to contradict the reported importance of carbohydrate malabsorption in short bowel (SB) patients. The aim of the present study was to investigate the occurrence of malabsorption in these patients ingesting realistic amounts of carbohydrates. We performed a dose-response study [ingestion of increasing amounts of glucose and complex carbohydrates (boiled rice and wheat bread), and the nonabsorbable disaccharide lactulose] in SB patients with an intact colon. The hydrogen (H2) -breath test and changes in serum acetate were used to evaluate colonic fermentation and, thus, indirectly, the lack of small intestinal carbohydrate assimilation. Blood glucose and plasma insulin were measured to evaluate absorption. Plasma concentrations of the ileal brake hormones--glucagon-like peptide-1 (GLP-1) and peptide tyrosine tyrosine (PYY)--were measured to test whether release of these hormones was related to colonic fermentation. Significant amounts of 25 g and 50 g glucose, and of the bread and rice meals were fermented rather than absorbed, as judged by the increases in end-expiratory H2. Serum acetate concentrations were significantly higher in SB patients than in healthy controls. The orocecal transit times of all test meals ranged from 15 to 120 min. GLP-1 and PYY releases in SB patients were significantly higher than in healthy volunteers. They were mutually parallel and paralleled the increase in insulin. They were not related to ongoing fermentation or to intraluminal carbohydrate content per se, but most probably to absorption of glucose in the distal bowel. In conclusion, well-adapted SB patients had pronounced small intestinal malabsorption of carbohydrate, even after ingestion of small amounts of easily absorbable carbohydrates. A fast small intestinal spreading of carbohydrates, once in the small intestine, and a spill-over to the colon seem to explain the data best.
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Affiliation(s)
- M Olesen
- Department of Medical Gastroenterology F, Copenhagen County Hospital, Gentofte, Hellerup, Denmark
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Kjøller E, Køber L, Jørgensen S, Torp-Pedersen C. Long-term prognostic importance of hyperkinesia following acute myocardial infarction. TRACE Study Group. TRAndolapril Cardiac Evaluation. Am J Cardiol 1999; 83:655-9. [PMID: 10080414 DOI: 10.1016/s0002-9149(98)00962-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The long-term prognostic importance of hyperkinesia is unknown following an acute myocardial infarction (AMI). The American Society of Echocardiography recommends that hyperkinesia should not be included in calculation of wall motion index (WMI). The objective of the present study was to determine if hyperkinesia should be included in WMI when it is estimated for prognostic purposes following an AMI. Six thousand, six hundred seventy-six consecutive patients were screened 1 to 6 days after AMI in 27 Danish hospitals. WMI was measured in 6,232 patients applying the 9-segment model and the following scoring system: 3 for hyperkinesia, 2 for normokinesia, 1 for hypokinesia, 0 for akinesia, and -1 for dyskinesia. All patients were followed with respect to mortality for at least 3 years. WMI was calculated in 2 different ways: 1 including hyperkinetic segments (hyperkinetic-WMI) and the other excluding nonhyperkinetic segments (nonhyperkinetic-WMI) by converting the hyperkinetic segments to normokinetic segments. Hyperkinesia occurred in 736 patients (11.8%). WMI was an important prognostic factor (relative risk 2.49; p = 0.0001) for long-term mortality together with heart failure, history of hypertension, angina, or diabetes, previous AMI, age, thrombolytic therapy, arrhythmias, and bundle branch block. In a multivariate analysis including nonhyperkinetic-WMI, hyperkinesia was associated with a relative risk of 0.84, which was statistically significant (confidence intervals 0.74 to 0.96; p = 0.01). When hyperkinesia was included, both in WMI (hyperkinetic-WMI) and as an independent variable, no additional prognostic information (relative risk 0.93; p = 0.26) was obtained. An echocardiographic evaluation shortly after an AMI gave important prognostic information, especially if the information concerning hyperkinesia was included. If WMI is used for prognostic purposes, hyperkinesia should be included in calculation of the index.
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Affiliation(s)
- E Kjøller
- Department of Medicine, Amager Hospital, Skt Elisabeth, Copenhagen, Denmark.
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Køber L, Torp-Pedersen C, Jørgensen S, Eliasen P, Camm AJ. Changes in absolute and relative importance in the prognostic value of left ventricular systolic function and congestive heart failure after acute myocardial infarction. TRACE Study Group. Trandolapril Cardiac Evaluation. Am J Cardiol 1998; 81:1292-7. [PMID: 9631965 DOI: 10.1016/s0002-9149(98)00158-1] [Citation(s) in RCA: 44] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Changes in the importance of left ventricular (LV) systolic dysfunction and congestive heart failure (CHF) with time after an acute myocardial infarction (AMI) after the introduction of thrombolytic therapy have not been studied. LV systolic function, measured as wall motion index (WMI) by echocardiography, was assessed in 6,676 consecutive patients with an enzyme-confirmed AMI. So that changes in the prognostic value of WMI or CHF could be studied, separate analyses were performed at selected time periods. Average monthly mortality (deaths per 100 patients per month) was determined from life-table analyses, with groups divided by WMI above and below 1.2 (a WMI > 1.2 corresponds to an ejection fraction > 0.35) or by presence and/or absence of CHF. Relative risk (95% confidence intervals [CI]) was determined by proportional hazard models, including baseline characteristics. In patients with LV dysfunction or CHF, monthly mortality was high during the first month (18.3 +/- 1.6% and 20.2 +/- 1.6%, respectively), decreased during the first year, and was stable thereafter (0.8 +/- 0.1% and 1.0 +/- 0.1%, respectively, average monthly mortality after year 3). The relative risk of LV dysfunction decreased from 2.4 (CI 2.0 to 2.9) to 1.3 (CI 1.0 to 1.6) in the same period. The relative risk of CHF decreased from 2.9 (CI 2.3 to 3.8) to 1.6 (CI 1.3 to 2.0). In patients without LV dysfunction or CHF, monthly mortality was relatively high during the first month (5.2% +/- 0.7% and 3.4% +/- 0.6%, respectively) but decreased within the first year to low, stable values (0.6% +/- 0.1% and 0.4% +/- 0.1%, respectively, average monthly mortality after year 3). In patients who received thrombolytic therapy, the relative risk associated with a WMI < or = 1.2 decreased from 3.0 (CI 2.0 to 4.4) to 1.3 (CI 0.9 to 1.6) and from 3.2 (CI 2.0 to 5.1) to 1.7 (CI 1.2 to 2.4) in patients with CHF. The risk of dying decreases steeply with time after an AMI with or without LV dysfunction or CHF and stabilizes at low values after 1 year. This is in contrast to the relative importance of these risk factors, which is maintained for > or = 5 years but decreases with time.
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Affiliation(s)
- L Køber
- Department of Cardiology P, Gentofte University Hospital of Copenhagen, Denmark
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33
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Ottesen MM, Køber L, Jørgensen S, Torp-Pedersen CT. [Delay from start of symptoms to hospital admission among 5.978 patients with acute myocardial infarction]. Ugeskr Laeger 1998; 160:1645-51. [PMID: 9522659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The aim of this study was to analyse the influence of patient characteristics on delay between onset of symptoms and hospital admission (patient delay) in acute myocardial infarction. A group of 6676 consecutive patients with AMI, admitted alive to 27 Danish hospitals from 1990 to 1992, were studied. Due to missing information on delay or in hospital acute myocardial infarction 698 patients were excluded. Mean patient delay was 9.1 hours, median delay 3.25 hours (5 to 95 percentiles: 0.67-40 hours). In multivariate logistic regression analysis patient delay was independently associated with male gender, increased age, diabetes mellitus, left ventricular systolic function (wall motion index), onset from midnight to 6 a.m., onset on a weekday, history of angina pectoris, chest pain as initial symptom, ventricular fibrillation or-tachycardia, Killip class > or = 3, presence of ST-elevation and ST-depressions. In conclusion, patient delay continues to be disappointingly long. This also applies to patients with a high risk of acute myocardial infarction (notably history of diabetes mellitus and angina pectoris).
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Affiliation(s)
- M M Ottesen
- Kardiologisk afdeling P, Amtssygehuset i Gentofte
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34
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Abstract
BACKGROUND The long-term effects of jejunoileostomy for morbid obesity were studied 15-20 years after surgery, in 60 patients. METHODS A total of 141 patients underwent surgery during the years 1973 to 1979. Thirty-four (24%) had had bowel continuity reestablished because of side effects. Eight (5.6%) were dead, 4 (2.8%) had emigrated, and 11 (7.8%) lived in remote areas, leaving 84 patients for follow-up. Sixty of these patients agreed to participate in the study. Seventy-seven per cent of the study population were women, with a mean age of 50 years. RESULTS The average weight loss was 50.2 kg; only one patient had regained the preoperative weight. The average weight was 84.2 kg. Reported side effects were 1) gastrointestinal: diarrhoea (61.7%), bad defecation smells (60%), and meteorism (11.7%), and 2) systemic: arthralgia (18.3%) and symptomatic nephro/cholelithiasis (18.3%). Forty-two patients (70% of the participants) found the results acceptable/satisfactory. Nine patients (15%) had vitamin B12 injections regularly; another 22 (35%) were found to have a low cobalamin level, and 35 patients (58%) had reduced P-magnesium. The 25-hydroxycholecalciferol level was low in 26 patients (43%), parathyroid hormone values were increased in 18 (30%). Fifty-seven patients (95%) had a P-carotene value lower than the normal limit. CONCLUSION These results stress the need for continuous control and supplementary therapy.
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Affiliation(s)
- S Jørgensen
- Dept. of Medical Gastroenterology F, Gentofte University Hospital, Hellerup, Denmark
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Nørregaard J, Jørgensen S, Mikkelsen KL, Tønnesen P, Iversen E, Sørensen T, Søeberg B, Jakobsen HB. The effect of ephedrine plus caffeine on smoking cessation and postcessation weight gain. Clin Pharmacol Ther 1996; 60:679-86. [PMID: 8988071 DOI: 10.1016/s0009-9236(96)90217-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVES To evaluate the efficacy of a combination of ephedrine and caffeine on smoking cessation rates, postcessation weight gain, and withdrawal symptoms and to examine changes in glycosylated hemoglobin (HbA1c) after smoking cessation. METHODS This randomized double-blind placebo-controlled study with a 1-year follow-up period was carried out at the Department of Pulmonary Medicine in Denmark. Study subjects were 225 heavy smokers who wanted to quit smoking without gaining weight. Two-thirds of the subjects were randomized to receive 20 mg ephedrine plus 200 mg caffeine three times a day; one-third of the subjects received placebo treatment. The dosage was gradually decreased from week 12 to discontinuation at week 39. Group support and control were performed at entry and after 1, 3, 6, 12, 26, 39, and 52 weeks. Main outcome measures were (1) self-reported abstinence with validation by carbon monoxide in expired air and serum cotinine and (2) weight gain. RESULTS The success rates after 1 year were 17% in the group treated with ephedrine plus caffeine and 16% in the group treated with placebo; the success rates were not significantly different at any time. The success rates for the four counseling physicians varied between 7% and 27% after 1 year (p < 0.05). The weight gain was significantly lower in the ephedrine plus caffeine-treated group during the first 12 weeks, but weight gains were similar after 1 year. No differences in the smoking withdrawal symptoms could be observed between the treatment groups. HbA1c was lower 6 weeks and 1 year after smoking cessation (p < 0.05). CONCLUSIONS We found an effect of this combination of ephedrine and caffeine on weight gain during the first 12 weeks, but we found no effect on the success rates or craving for cigarettes.
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Affiliation(s)
- J Nørregaard
- Department of Pulmonary Medicine P, Bispebjerg Hospital, Copenhagen, Denmark
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36
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Abstract
The primary aim of this smoking cessation study was to evaluate the effect of long-term treatment with nicotine nasal spray in a group of hard-core smokers. A further aim was to compare the effect of ad libitum with fixed dosage of nasal nicotine spray. Eighty nine smokers, failures from two earlier studies with nicotine patches, were enrolled in an open smoking cessation study with nicotine nasal sprays, to be used ad libitum (n=45) or on a fixed schedule of 1 mg x h-1 during the day (n= 44). Carbon monoxide-verified continuous abstinence from smoking beyond Week 2, was 39% at 3 weeks, 12% at 3 months, 10% at 6 months and 6% after 1 yr, with no significant difference in success rate between ad libitum and fixed dosing. Mean daily nicotine dose was 15-16 mg during the first 3 months (range 2-65 mg). Tolerance to local irritating side-effects of nicotine developed during the first weeks of use. Although short-term outcome was promising, the long-term success rate in this group of hardcore smokers was low. Other recycling set-ups are warranted, which might include more aggressive nicotine dosing.
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Affiliation(s)
- P Tønnesen
- Dept of Pulmonary Diseases, Bispebjerg Hospital and Gentofte Hospital, Copenhagen, Denmark
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37
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Ottesen MM, Køber L, Jørgensen S, Torp-Pedersen C. Determinants of delay between symptoms and hospital admission in 5978 patients with acute myocardial infarction. The TRACE Study Group. Trandolapril Cardiac Evaluation. Eur Heart J 1996; 17:429-37. [PMID: 8737218 DOI: 10.1093/oxfordjournals.eurheartj.a014876] [Citation(s) in RCA: 70] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
The aim of this study was to analyse the influence of patient characteristics on delay between onset of symptoms and hospital admission (patient delay) in acute myocardial infarction, and especially to assess the impact of risk factors for acute myocardial infarction on patient delay. A group of 6676 consecutive patients with enzyme-confirmed acute myocardial infarction, admitted alive to 27 Danish hospitals over a 26 month period from 1990 to 1992, were studied. Due to missing information on delay or in-hospital acute myocardial infarction 698 patients were excluded, leaving 5978 patients for analysis. Mean patient delay was 9.1 h, median delay 3.25 h (5 to 95 percentiles: 0.67-40.0 h). Thirty-four percent were admitted within the first 2 h, 68% within 6 h and 81% within 12 h of onset of symptoms. In multivariate logistic regression analysis, a greater than 2 h patient delay was independently associated with male gender (odds ratio (OR) = 0.809, P = 0.003), increased age (P = 0.0001), diabetes mellitus (OR = 1.269, P = 0.03), left ventricular systolic function (wall motion index) (P = 0.02), onset from midnight to 0600h (OR = 1.434, P = 0.0001), onset on a weekday (OR = 0.862, P = 0.04), history of angina pectoris (OR = 1.198, P = 0.02), chest pain as initial symptom (OR = 1.293, P = 0.02), ventricular fibrillation (OR = 0.562, P = 0.0001), ventricular tachycardia (OR = 0.620, P = 0.0001), Killip class > or = 3 (OR = 0.709 P = 0.002), presence of ST elevation (OR = 0.810, P = 0.01) and ST depressions (OR = 0.847, P = 0.01). All these variables, except history of diabetes mellitus, angina pectoris, and chest pain as an initial symptom were also associated with a delay of more than 6 h. Thrombolytic therapy was administered to 55.8% of patients admitted within 2 h of an acute myocardial infarction, 48.5% of patients admitted within 2-6 h, 31.5% of patients admitted after 6-12 h and 11.9% of patients arriving later than 12 h after start of symptoms. CONCLUSION. Patient delay continues to be disappointingly long. This also applies for patients at a high risk of acute myocardial infarction (notably those with a history of diabetes mellitus and angina pectoris).
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Affiliation(s)
- M M Ottesen
- Department of Cardiology P, Gentofte University Hospital, Copenhagen, Denmark
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38
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Jørgensen S. 1321 Hospice lovisenberg is a day-care center in Oslo, capital of Norway, established as an offer to people with terminal cancer and other serious ailments. Eur J Cancer 1995. [DOI: 10.1016/0959-8049(95)96567-w] [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: 10/27/2022]
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Nielsen OH, Jørgensen S, Pedersen K, Justesen T. Microbiological evaluation of jejunal aspirates and faecal samples after oral administration of bifidobacteria and lactic acid bacteria. J Appl Bacteriol 1994; 76:469-74. [PMID: 8005834 DOI: 10.1111/j.1365-2672.1994.tb01104.x] [Citation(s) in RCA: 23] [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] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
A double-blind placebo controlled investigation was carried out to study the effect of peroral colonization. Human volunteers were given mixtures of bifidobacteria and lactic acid bacteria. Measurements were made over a 1 week treatment period and for another week after the end of the treatment. Two different bacteriological preparations were used, one consisted of Enterococcus faecium and Bifidobacterium longum (a total of 6.4 x 10(8) cfu d-1); the other consisted of Lactobacillus acidophilus, Bif. bifidum, Lact. delbrueckii ssp. bulgaricus, and Streptococcus thermophilus (a total of 9 x 10(9) cfu d-1). Together with a placebo preparation, they were given to 24 healthy controls (eight in each group). Microbiological examinations of jejunal aspirates showed that viable counts of most species were below the detection limit. However, the test preparation containing Ent. faecium and Bif. longum significantly reduced the anaerobe: aerobe ratio in faeces by a factor of three during treatment (P = 0.03), and increased it by a factor of 30 during the following week (P < 0.02). This study shows that peroral administration of certain bacterial cultures may affect the distal intestinal microflora.
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Affiliation(s)
- O H Nielsen
- Department of Internal Medicine, Sct. Elisabeth Hospital, Copenhagen, Denmark
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40
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Abstract
Lifting of heavy burdens increases the intra-abdominal pressure, and may induce an increased risk of prolapse of the female internal genitals. While taking care of patients, the nursing staff in hospitals and nursing homes are exposed to heavy lifting. Scientifically uncontrolled causal observations among assistant nurses gave rise to the assumption of an increased risk. To test this hypothesis, a register study was carried out to investigate the risk of genital prolapse among assistant nurses compared with the female Danish population in general. For validation, the incidence of operation due to herniated lumbar disc was investigated. Two registers were used for the analyses, a pension fund register and the Danish National Registry of Hospitalized Patients. Some 28,619 assistant nurses, aged 20-69 years, and 1,652,533 controls of similar age were included. Operations due to genital prolapse and herniated lumbar disc were recorded during one year. The odds ratio (OR) with 95 per cent confidence intervals for the risk of operation due to genital prolapse was significantly increased among assistant nurses, OR = 1.6 (1.3-1.9), P < 0.0001. Correspondingly, the risk of operation for herniated lumbar disc was significantly increased for assistant nurses, OR = 1.6 (1.2-2.2), P < 0.01. We conclude that operations due to genital prolapse are more common among assistant nurses than among the overall female population. Based on this finding, we hypothesize that heavy lifting at work may be the underlying cause. This study confirmed the suggestion of previous epidemiological studies that herniated lumbar disc is associated with heavy lifting at work.
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Affiliation(s)
- S Jørgensen
- Epidemiological Research Unit, Clinic of Occupational Medicine, Rigshospitalet, State University Hospital, Copenhagen, Denmark
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41
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Abstract
In a multicenter study conducted at four Danish hospital pediatric departments, the parents of 472 consecutive children were informed of this project to determine the incidence of intolerance of food additives among children referred to an allergy clinic with symptoms of asthma, atopic dermatitis, rhinitis, or urticaria. After a 2-week period on an additive-free diet, the children were challenged with the eliminated additives. The food additives investigated were coloring agents, preservatives, citric acid, and flavoring agents. Carbonated "lemonade" containing the dissolved additives was used for the open challenge. Two doses were used: a low dose and a 10-fold higher dose. Gelatin capsules were used for a double-blind challenge. The children were 4-15 years old, and they were attending an outpatient pediatric clinic for the first time. Of the 379 patients who entered the study, 44 were excluded and 335 were subjected to open challenge. A total of 23 children developed positive reactions after the open challenge. Sixteen of these patients accepted the double-blind challenge, and six showed a positive reaction to preservatives (atopic dermatitis, asthma, rhinitis), coloring agents (atopic dermatitis, asthma, urticaria, gastrointestinal symptoms), and citric acid (atopic dermatitis, gastrointestinal symptoms). The incidence of intolerance of food additives was 2% (6/335), as based on the double-blind challenge, and 7% (23/335), as based on the open challenge with lemonade. Children with atopic skin symptoms had a statistically increased risk of a positive reaction. This may have consequences for the future clinical investigation of children with atopic cutaneous symptoms.
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Affiliation(s)
- G Fuglsang
- Department of Pediatrics, Viborg Hospital, Denmark
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Rossvoll I, Benum P, Bredland TR, Solstad K, Arntzen E, Jørgensen S. Incapacity for work in elective orthopaedic surgery: a study of occurrence and the probability of returning to work after treatment. J Epidemiol Community Health 1993; 47:388-94. [PMID: 8289040 PMCID: PMC1059834 DOI: 10.1136/jech.47.5.388] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
STUDY OBJECTIVE The extent to which patients undergoing elective surgery for orthopaedic disorders were incapacitated for work while they were on the waiting list and whether they were able to return to work after surgery were studied. DESIGN This was a prospective cohort study of patients admitted to hospital for elective orthopaedic surgery. Main outcome measures were occurrence of sickness certification during the waiting time, and whether those incapacitated for work at the time of surgery returned to work during the first year after treatment. Multivariate logistic regression was used to estimate adjusted odds ratios for factors influencing return to work. SETTING Orthopaedic department in charge of all elective orthopaedic surgery in a population of 197,354 persons in central Norway. SUBJECTS All 2803 patients admitted to hospital for chronic orthopaedic disorders in the defined population between 1 September 1988 and 31 August 1990 were included in the study. MAIN RESULTS Of the 1333 patients who were employed, 42% had been certified sick due to the orthopaedic disorder for some period of the waiting time. Sickness benefits from the national insurance scheme (paid from the 15th day of sickness certification) had been received by 33% and were received by 29% at the time of surgery. Of 380 patients incapacitated for work at the time of surgery, 53% returned to work within the first year after surgery. Using those treated within one month of being placed on the waiting list as the reference group, the adjusted odds ratios for not returning to work during the first year after surgery were 9.2 (p < 0.0001) for those who waited more than a year for surgery, 6.2 (p = 0.002) for those waiting nine to 12 months, and 4.9 (p = 0.02) for those waiting for six to nine months. CONCLUSIONS A high proportion of these patients were incapacitated for work, 53% of those incapacitated returned to work within the first year after surgery. The probability of returning to work after surgery is strongly influenced by the length of time on the waiting list. Waiting for more than one year, compared with immediate treatment, was associated with an adjusted odds ratio of 9.2 for not returning to work.
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Affiliation(s)
- I Rossvoll
- Department of Orthopaedic Surgery, Trondheim University Hospital, Norway
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Jørgensen S, Nürnberg BM, Tørholm C. [Squamous cell carcinoma developing in chronic fistulating osteomyelitis]. Ugeskr Laeger 1993; 155:2277-8. [PMID: 8328100] [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: 01/29/2023]
Abstract
Two cases of carcinoma which had developed in chronic fistulating osteomyelitis are presented. In one case the patient was cured by an above-the-knee-amputation. In the other case the patient was also treated by amputation, but died of metastases. The need for active surgical treatment of chronic osteomyelitis is emphasized.
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Affiliation(s)
- S Jørgensen
- Orthopaedkirurgisk afdeling, Københavns Amts Sygehus, Gentofte, patologisk-anatomisk institut
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44
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Jørgensen S. [The right values and the wrong ones]. Sygeplejersken 1993; 93:32-3. [PMID: 8115967] [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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45
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Tønnesen P, Nørregaard J, Mikkelsen K, Jørgensen S, Nilsson F. A double-blind trial of a nicotine inhaler for smoking cessation. JAMA 1993; 269:1268-71. [PMID: 8437304] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
OBJECTIVE To evaluate the efficacy of a new nicotine inhaler system for smoking cessation. DESIGN A 1-year, randomized, double-blind, placebo-controlled study. SETTING Medical outpatient clinic with physicians experienced in smoking cessation assistance. SUBJECTS A total of 286 volunteers who smoked at least 10 cigarettes daily recruited through a local newspaper. INTERVENTION Subjects were randomly allocated to nicotine inhalers (n = 145) or placebo (n = 141) to be used for 3 months followed by tapering for 3 months in the context of minimal levels of advice and support. MAIN OUTCOME MEASURE Continuous smoking abstinence at weeks 6, 12, 24, and 52, verified by measurements of carbon monoxide in expired air. RESULTS Continuous smoking abstinence was significantly higher for the active nicotine inhaler group compared with the placebo inhaler group. The respective success rates were 28% and 12% after 6 weeks, 21% and 9% after 12 weeks, 17% and 8% after 6 months, and 15% and 5% after 1 year (P = .02 to .001). The mean nicotine substitution based on cotinine determinations after 2 weeks was 43% (SD, 45%) of smoking levels. The treatment was well tolerated, and no serious adverse events were reported. CONCLUSIONS In this setting the nicotine inhaler appeared safe to use and increased success rates of smoking cessation attempts.
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Affiliation(s)
- P Tønnesen
- Department of Pulmonary Medicine, Bispebjerg Hospital, Copenhagen, Denmark
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Abstract
To compare the effect on glucose recovery after insulin-induced hypoglycaemia of intramuscular genetically engineered glucagon, intramuscular glucagon from pancreatic extraction and intravenous glucose, we examined 10 healthy subjects during blockage of glucose counterregulation with somatostatin, propranolol and phentolamine. Each subject was studied on three separate occasions. Thirty min after a bolus injection of 0.075 iu soluble insulin per kilogram body weight the subjects received one of the following treatments: 1 mg glucagon from pancreatic extraction intramuscularly; 1 mg genetically engineered glucagon intramuscularly; and 25 g glucose intravenously, respectively. The two glucagon preparations induced an equally rapid increase in plasma glucose. This was due to an abrupt (within 4 min) and equal increase in glucose appearance rate. The increases in both plasma glucose and in glucose appearance rate were far more protracted after i.m. glucagon than after i.v. glucose. These results suggest that genetically engineered glucagon and glucagon from pancreatic extraction have a similar effect on hepatic glucose production rate. Due to the protracted effect of intramuscular glucagon, a combined treatment consisting of both intravenous glucose and intramuscular glucagon may be more effective in the treatment of hypoglycaemia than any of these given alone.
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Affiliation(s)
- A Hvidberg
- Department of Internal Medicine and Endocrinology, Hvidovre University Hospital, Copenhagen, Denmark
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47
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Abstract
The techniques of anesthesia for extracorporeal shock wave lithotripsy of urinary calculi and the associated complications in 600 treatments with the second generation lithotriptor Siemens Lithostar were studied. General anesthesia was used in 17 treatments (2.8%) and epidural anesthesia was applied in 73 (12%), primarily in children and patients in need of simultaneous surgical auxiliary procedures. A total of 510 treatments (85%) was performed with a combination of local infiltration anesthesia and supplementary intravenous opiates. In 65% of the cases only 2 injections of opiates were sufficient for pain relief. There were no complications in 394 treatments (77%) and minor complications, such as arrhythmia (9.2%) and nausea/vomiting (7.6%), were easily treated. Respiratory depression was observed in 10 cases (2%) and this potentially dangerous complication was associated with simultaneous administration of opiates and midazolam. Only 9 treatments (1.8%) had to be terminated due to complications. It is concluded that most treatments of urinary calculi with this second generation extracorporeal shock wave lithotriptor can be performed with local infiltration anesthesia combined with supplementary short-acting opiates intravenously for pain relief and sedation. When administering supplementary midazolam for sedation the risk of respiratory depression should be considered.
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Affiliation(s)
- F Knudsen
- Department of Anesthesiology, Bispebjerg Hospital, Copenhagen, Denmark
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48
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Abstract
The aim of this study was to compare the effect of nasally administered glucagon in doses of 1 (A) and 2 mg (B), with 1 mg glucagon administered intramuscularly (C) in 12 C-peptide-negative IDDM patients. Spontaneous recovery (D) from insulin-induced hypoglycaemia in the same patients was used as reference. The mean age was 31.1 (21-48) years, diabetes duration 10.8 (2.7-31) years and HbA1c 7.7 (6.5-9.8)%. Hypoglycaemia was induced by i.v. insulin infusion. When blood glucose (BG) reached about 2 mmol/l either glucagon was administered or the patients recovered spontaneously. BG nadir was 1.6 (1.1-2.3) mmol/l. BG increments during the first 15 min after glucagon administration were: (A) 1.9 +/- 0.7 (0.4-3.0); (B) 2.5 +/- 0.7 (1.5-3.5); (C) 2.5 +/- 1.0 (1.2-4.7); and (D) 0.3 +/- 0.4 (0-1.0) mmol/l, respectively. All treatments were more effective, measured as increments in BG, than spontaneous recovery, P less than 0.00001. There was no difference between nasal treatment with 2 mg (B) and i.m. treatment (C), both being more effective than 1 mg (A) nasal treatment, P less than 0.1. BG continued to increase up to 10 mmol/l 90 min after i.m. glucagon administration, whereas it stabilized at a level of 4.6-6 mmol/l, 30-45 min after nasal administration. Eighty percent of the patients had side-effects to nasal administration - local irritation, rhinitis or sneezing. Half of the patients sneezed, without correlation with the delivered dose of glucagon. None of the patients had side-effects which would preclude further treatment.(ABSTRACT TRUNCATED AT 250 WORDS)
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Abstract
The efficacy of fluvoxamine on cognitive functioning and behavioral changes was evaluated in a double-blind, placebo-controlled study of 46 elderly demented patients. The patients had a DSM-III diagnosis of primary degenerative dementia or multi-infarct dementia and were aged greater than or equal to 65 years. Twenty-two patients were given 150 mg fluvoxamine per day and 24 received placebo tablets; 14 and 15 patients, respectively, completed 6 weeks of treatment. Within treatments, there were no significant changes in median scores on neuropsychological tests (picture recall and recognition, trail making and finger tapping) or the GBS scale scores (degrees of dementia) or GBS subscale score (clinical profiles, including symptoms common in dementia, motor, emotional and intellectual functioning). Between treatments, the median changes in psychometric test scores did not differ significantly. However, within and between treatments, there were trends favoring fluvoxamine on symptoms common in dementia (confusion, irritability, anxiety, fear-panic, mood level and restlessness). In conclusion, the study does not support the hypothesis that fluvoxamine improves cognitive functioning or behavioral changes in elderly dementia patients.
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Affiliation(s)
- K Olafsson
- Psychogeriatric Department, Vordingsborg Psychiatric Hospital, Denmark
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50
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Jørgensen S. [Femoral neck fractures in Troms and Oslo in 1989]. Tidsskr Nor Laegeforen 1992; 112:1060. [PMID: 1553736] [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: 12/27/2022] Open
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