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Okkels N, Horsager J, Labrador-Espinosa M, Kjeldsen PL, Damholdt MF, Mortensen J, Vestergård K, Knudsen K, Andersen KB, Fedorova TD, Skjærbæk C, Gottrup H, Hansen AK, Grothe MJ, Borghammer P. Severe cholinergic terminal loss in newly diagnosed dementia with Lewy bodies. Brain 2023; 146:3690-3704. [PMID: 37279796 DOI: 10.1093/brain/awad192] [Citation(s) in RCA: 3] [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: 01/23/2023] [Revised: 05/03/2023] [Accepted: 05/23/2023] [Indexed: 06/08/2023] Open
Abstract
Cholinergic changes play a fundamental role in the natural history of dementia with Lewy bodies and Lewy body disease in general. Despite important achievements in the field of cholinergic research, significant challenges remain. We conducted a study with four main objectives: (i) to examine the integrity of cholinergic terminals in newly diagnosed dementia with Lewy bodies; (ii) to disentangle the cholinergic contribution to dementia by comparing cholinergic changes in Lewy body patients with and without dementia; (iii) to investigate the in vivo relationship between cholinergic terminal loss and atrophy of cholinergic cell clusters in the basal forebrain at different stages of Lewy body disease; and (iv) to test whether any asymmetrical degeneration in cholinergic terminals would correlate with motor dysfunction and hypometabolism. To achieve these objectives, we conducted a comparative cross-sectional study of 25 newly diagnosed dementia with Lewy bodies patients (age 74 ± 5 years, 84% male), 15 healthy control subjects (age 75 ± 6 years, 67% male) and 15 Parkinson's disease patients without dementia (age 70 ± 7 years, 60% male). All participants underwent 18F-fluoroetoxybenzovesamicol PET and high-resolution structural MRI. In addition, we collected clinical 18F-fluorodeoxyglucose PET images. Brain images were normalized to standard space and regional tracer uptake and volumetric indices of basal forebrain degeneration were extracted. Patients with dementia showed spatially distinct reductions in cholinergic terminals across the cerebral cortex, limbic system, thalamus and brainstem. Also, cholinergic terminal binding in cortical and limbic regions correlated quantitatively and spatially with atrophy of the basal forebrain. In contrast, patients without dementia showed decreased cholinergic terminal binding in the cerebral cortex despite preserved basal forebrain volumes. In patients with dementia, cholinergic terminal reductions were most severe in limbic regions and least severe in occipital regions compared to those without dementia. Interhemispheric asymmetry of cholinergic terminals correlated with asymmetry of brain metabolism and lateralized motor function. In conclusion, this study provides robust evidence for severe cholinergic terminal loss in newly diagnosed dementia with Lewy bodies, which correlates with structural imaging measures of cholinergic basal forebrain degeneration. In patients without dementia, our findings suggest that loss of cholinergic terminal function occurs 'before' neuronal cell degeneration. Moreover, the study supports that degeneration of the cholinergic system is important for brain metabolism and may be linked with degeneration in other transmitter systems. Our findings have implications for understanding how cholinergic system pathology contributes to the clinical features of Lewy body disease, changes in brain metabolism and disease progression patterns.
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Affiliation(s)
- Niels Okkels
- Department of Nuclear Medicine and PET, Aarhus University Hospital, 8200 Aarhus N, Denmark
- Department of Clinical Medicine, Aarhus University, 8000 Aarhus C, Denmark
- Department of Neurology, Aarhus University Hospital, 8200 Aarhus N, Denmark
| | - Jacob Horsager
- Department of Nuclear Medicine and PET, Aarhus University Hospital, 8200 Aarhus N, Denmark
- Department of Clinical Medicine, Aarhus University, 8000 Aarhus C, Denmark
| | - Miguel Labrador-Espinosa
- Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, 41013 Seville, Spain
- Centro de Investigación Biomédica en Red Sobre Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Pernille L Kjeldsen
- Department of Nuclear Medicine and PET, Aarhus University Hospital, 8200 Aarhus N, Denmark
- Department of Clinical Medicine, Aarhus University, 8000 Aarhus C, Denmark
- Department of Neurology, Aalborg University Hospital, 9000 Aalborg, Denmark
| | - Malene F Damholdt
- Department of Clinical Medicine, Aarhus University, 8000 Aarhus C, Denmark
| | - Janne Mortensen
- Department of Neurology, Aarhus University Hospital, 8200 Aarhus N, Denmark
| | - Karsten Vestergård
- Department of Neurology, Aalborg University Hospital, 9000 Aalborg, Denmark
| | - Karoline Knudsen
- Department of Nuclear Medicine and PET, Aarhus University Hospital, 8200 Aarhus N, Denmark
- Department of Clinical Medicine, Aarhus University, 8000 Aarhus C, Denmark
| | - Katrine B Andersen
- Department of Nuclear Medicine and PET, Aarhus University Hospital, 8200 Aarhus N, Denmark
- Department of Clinical Medicine, Aarhus University, 8000 Aarhus C, Denmark
| | - Tatyana D Fedorova
- Department of Nuclear Medicine and PET, Aarhus University Hospital, 8200 Aarhus N, Denmark
- Department of Clinical Medicine, Aarhus University, 8000 Aarhus C, Denmark
| | - Casper Skjærbæk
- Department of Nuclear Medicine and PET, Aarhus University Hospital, 8200 Aarhus N, Denmark
- Department of Clinical Medicine, Aarhus University, 8000 Aarhus C, Denmark
| | - Hanne Gottrup
- Department of Neurology, Aarhus University Hospital, 8200 Aarhus N, Denmark
| | - Allan K Hansen
- Department of Nuclear Medicine and PET, Aarhus University Hospital, 8200 Aarhus N, Denmark
- Department of Nuclear Medicine, Aalborg University Hospital, 9000 Aalborg, Denmark
| | - Michel J Grothe
- Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, 41013 Seville, Spain
- Centro de Investigación Biomédica en Red Sobre Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Per Borghammer
- Department of Nuclear Medicine and PET, Aarhus University Hospital, 8200 Aarhus N, Denmark
- Department of Clinical Medicine, Aarhus University, 8000 Aarhus C, Denmark
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Wang X, Mortensen J, Sengeloev H, Kjaer-Kristoffersen F, Meidahl Petersen P, Specht L. PD-0171 Lung function after total body irradiation in myeloablative allogeneic stem cell transplantation. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02776-1] [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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Ibsen D, Christiansen A, Olsen A, Tjønneland A, Overvad K, Wolk A, Mortensen J, Dahm C. Adherence to the Eat-Lancet Diet and Risk of Stroke and Stroke Subtypes – A Danish Cohort Study. Curr Dev Nutr 2021. [DOI: 10.1093/cdn/nzab038_026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Objectives
To investigate the association between adherence to the EAT-Lancet diet, a sustainable and mostly plant-based diet, and risk of stroke and subtypes of stroke in a Danish population. To explore dietary guidelines that do not take the environmental impact into account, we investigated associations for adherence to the Alternate Healthy Eating Index-2010 (AHEI).
Methods
We used the Danish Diet, Cancer and Health cohort (n = 55,016) including men and women aged 50–64 years at baseline (1993–1997). A validated food frequency questionnaire was used to assess dietary intake. The EAT-Lancet diet score was the sum of adherence to 14 components (1 point = yes, 0 = no; score ranged 0–14). The AHEI included 11 components and scored relative adherence 0–10 point for each component (score ranged 0–110). Stroke cases were identified using the Danish National Patient Registry and subsequently validated by review of medical records (n = 2253, median follow-up time = 15 years). Cox proportional hazards models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for associations with the EAT-Lancet diet or the AHEI and risk of stroke and subtypes of stroke (ischemic stroke [IS, n = 1858], intracerebral hemorrhage [ICH, n = 267] and subarachnoid hemorrhage [SAH, n = 115]).
Results
In multivariable adjusted models, we found that adherence to the EAT-Lancet diet score was associated with a lower risk of stroke, although not statistically significant, comparing the highest level of adherence (11–14 points) with the lowest (0–7 points) (HR 0.91; 95% CI 0.76, 1.09). A lower risk was observed for the AHEI (highest [59–110 points] vs lowest adherence [0–40] 0.75; 0.64, 0.87). For stroke subtypes we found that adherence to the EAT-Lancet diet was associated with a lower risk of SAH (0.30; 0.12, 0.73) but not IS or ICH. In contrast, the AHEI was associated with a lower risk of IS (0.76; 0.64, 0.90) and ICH (0.58; 0.36, 0.93) but not SAH.
Conclusions
Adherence to the EAT-Lancet diet or the AHEI was associated with a lower risk of stroke in a Danish population. The EAT-Lancet diet was mainly associated with a lower risk of SAH, whereas the AHEI was mainly associated with a lower risk of IS and ICH.
Funding Sources
Aarhus University, Danish Cancer Society.
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Affiliation(s)
| | | | | | | | - Kim Overvad
- Department of Public Health, Aarhus University
| | - Alicja Wolk
- Institute of Environmental Medicine, Unit of Cardiovascular and Nutritional Epidemiology
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Lynggaard V, Zwisler AD, Taylor RS, May O, Mortensen J, Nielsen CV. Short- and long-term effects of the patient education strategy-learning and coping-in cardiac rehabilitation: a randomized controlled trial (LC-REHAB). Health Educ Res 2021; 36:41-60. [PMID: 33755118 DOI: 10.1093/her/cyaa051] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 12/02/2020] [Indexed: 06/12/2023]
Abstract
The objectives were to assess the short- and long-term effect of the patient education strategy 'Learning and Coping' (LC) in cardiac rehabilitation (CR) on health-related quality of life, patient education impact, cardiac risk factors and lifestyle. In total, 825 patients hospitalized with ischaemic heart disease or heart failure were randomized to either LC-CR or standard CR at three Danish hospitals. Teaching approach in LC-CR was situational, inductive and reflective, with experienced patients as co-educators and supplemental interviews. Teaching approach in standard CR was structured and deductive. Outcomes were assessed immediately after CR, and after 3 months (short term), and after 3 years (long term). Between-arm differences in favour of LC-CR were SF-12 'role emotional' (3.7, 95% CI: 0.6-6.8) and MDI depression score (0.9, 0.1-1.8) immediately after CR, exercise capacity (4 W, 1-9) at 3 months and SF-12 'role physical' (4.6, 0.1-9.0) (long term). Between-arm differences in favour of controls were waist circumference (-1.7 cm, -2.3 to -1.0) immediately after CR and HeiQ domain 'Constructive attitudes and approaches' (0.11, 0.04-0.18), triglycerides (-0.12 mmol/l, -0.21 to -0.02), systolic blood pressure (-3.12 mmHg, -5.66 to -0.58) at 3 months. Adding LC strategies to CR provides inconsistent short-term results but improves 'role physical' long term.
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Affiliation(s)
- V Lynggaard
- Cardiovascular Research Unit, Department of Cardiology, Gødstrup Hospital (Formerly known as Regional Hospital West Jutland), 61 Gammel Landevej, 7400 Herning, Denmark
| | - A D Zwisler
- Danish Knowledge Centre for Rehabilitation and Palliative Care, University Hospital Odense and University of Southern Denmark, Nyborg, Denmark
| | - R S Taylor
- Danish Knowledge Centre for Rehabilitation and Palliative Care, University Hospital Odense and University of Southern Denmark, Nyborg, Denmark
- MRC/CSO Social and Public Health Sciences Unit, Robertson Centre for Biostatistics, Institute of Health and Well Being, University of Glasgow, Glasgow, UK
| | - O May
- Department of Cardiology, Gødstrup Hospital, Herning, Denmark
| | - J Mortensen
- Department of Nuclear Medicine, Gødstrup Hospital, Herning, Denmark
| | - C V Nielsen
- Department of Public Health, Section of Social Medicine and Rehabilitation, Aarhus University, Aarhus, Denmark
- DEFACTUM, Central Denmark Region, Aarhus, Denmark
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Risom E, Buggeskov K, Petersen R, Mortensen J, Ravn H. The impact of reduced duffusing capacity of the lung for carbon monoxide and fev1 on outcome after cardiac surgery. J Cardiothorac Vasc Anesth 2020. [DOI: 10.1053/j.jvca.2020.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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6
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Ladegaard P, Mortensen J, Lund L. HP-08-007 A prospective randomized placebo controlled study evaluating the effect of Low-intensity Extracorporeal Shockwave Therapy (LI-ESWT) in men with erectile dysfunction following radical prostatectomy. J Sex Med 2019. [DOI: 10.1016/j.jsxm.2019.03.158] [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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Hopwood MJ, Carroll D, Browning TJ, Meire L, Mortensen J, Krisch S, Achterberg EP. Non-linear response of summertime marine productivity to increased meltwater discharge around Greenland. Nat Commun 2018; 9:3256. [PMID: 30108210 PMCID: PMC6092443 DOI: 10.1038/s41467-018-05488-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Accepted: 07/10/2018] [Indexed: 11/08/2022] Open
Abstract
Runoff from the Greenland Ice Sheet (GrIS) is thought to enhance marine productivity by adding bioessential iron and silicic acid to coastal waters. However, experimental data suggest nitrate is the main summertime growth-limiting resource in regions affected by meltwater around Greenland. While meltwater contains low nitrate concentrations, subglacial discharge plumes from marine-terminating glaciers entrain large quantities of nitrate from deep seawater. Here, we characterize the nitrate fluxes that arise from entrainment of seawater within these plumes using a subglacial discharge plume model. The upwelled flux from 12 marine-terminating glaciers is estimated to be >1000% of the total nitrate flux from GrIS discharge. This plume upwelling effect is highly sensitive to the glacier grounding line depth. For a majority of Greenland's marine-terminating glaciers nitrate fluxes will diminish as they retreat. This decline occurs even if discharge volume increases, resulting in a negative impact on nitrate availability and thus summertime marine productivity.
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Affiliation(s)
- M J Hopwood
- Marine Biogeochemistry, GEOMAR Helmholtz Centre for Ocean Research, Kiel, 24148, Germany.
| | - D Carroll
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA, 91109, USA
| | - T J Browning
- Marine Biogeochemistry, GEOMAR Helmholtz Centre for Ocean Research, Kiel, 24148, Germany
| | - L Meire
- Royal Netherlands Institute for Sea Research, and Utrecht University, Korringaweg 7, 4401 NT, Yerseke, The Netherlands
- Greenland Climate Research Centre, Greenland Institute of Natural Resources, PO BOX 570, 3900, Nuuk, Greenland
| | - J Mortensen
- Greenland Climate Research Centre, Greenland Institute of Natural Resources, PO BOX 570, 3900, Nuuk, Greenland
| | - S Krisch
- Marine Biogeochemistry, GEOMAR Helmholtz Centre for Ocean Research, Kiel, 24148, Germany
| | - E P Achterberg
- Marine Biogeochemistry, GEOMAR Helmholtz Centre for Ocean Research, Kiel, 24148, Germany
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Risom EC, Bredahl Buggeskov K, Mogensen U, Sundskard M, Mortensen J, Berg Ravn H. Preoperative pulmonary function in all comers for cardiac surgery predicts mortality. J Cardiothorac Vasc Anesth 2018. [DOI: 10.1053/j.jvca.2018.08.093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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9
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Skoradal MB, Weihe P, Patursson P, Mortensen J, Connolly L, Krustrup P, Mohr M. Football training improves metabolic and cardiovascular health status in 55- to 70-year-old women and men with prediabetes. Scand J Med Sci Sports 2018; 28 Suppl 1:42-51. [PMID: 29718556 DOI: 10.1111/sms.13081] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2018] [Indexed: 01/04/2023]
Abstract
We examined the effects of 16 weeks of football training and dietary advice on blood glucose control and health status in 55- to 70-year-old women and men with prediabetes. Fifty participants with prediabetes (age; 61 ± 6 years, BMI; 29.6 ± 4.7; VO2max 22.3 ± 5.7 mL·min-1 ·kg-1 ) were randomized into a football and dietary advice group (F+D; n = 27) and a dietary advice group (D; n = 23). F+D performed football training (twice weekly 30- to 60-minutes sessions) and received dietary advice, while D only received dietary advice. An oral glucose tolerance test (OGTT) was completed pre and post the 16-week period. Body composition, blood pressure, and maximal oxygen uptake (VO2max ) were additionally measured. Both groups demonstrated a decrement (P < .05) in fasting blood glucose (-0.4 ± 0.5 mmol·L-1 ) and lowered blood glucose throughout OGTT. F+D displayed lower values than D (P < .05) after 60 minutes (9.0 ± 2.7 vs 10.6 ± 2.9 mmol·L-1 ) and 120 minutes (5.7 ± 1.6 vs 7.5 ± 2.4 mmol·L-1 ). VO2max increased by 14% in F+D, with a higher (P < .05) change score than in D (2%). Mean arterial pressure declined more (P < .05) in F+D than in D (-8 ± 9 vs -4 ± 11 mm Hg). Fat loss was greater (P < .05) in F+D than in D (-3.4 ± 2.8 vs -1.2 ± 2.0 kg), and the increase in lean body mass was also greater (P < .05) in F+D than in D (0.7 ± 1.5 vs -0.3 ± 1.6 kg). In conclusion, football training combined with dietary advice has broad-spectrum effects on metabolic and cardiovascular health profile with greater overall effects than professional dietary advice per se for 55- to 70-year-old women and men with prediabetes.
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Affiliation(s)
- M-B Skoradal
- Faculty of Health Sciences, Centre of Health Science, University of the Faroe Islands, Tórshavn, Faroe Islands
| | - P Weihe
- Faculty of Health Sciences, Centre of Health Science, University of the Faroe Islands, Tórshavn, Faroe Islands.,Department of Occupational Medicine and Public Health, The Faroese Hospital System, Tórshavn, Faroe Islands
| | - P Patursson
- Faculty of Health Sciences, Centre of Health Science, University of the Faroe Islands, Tórshavn, Faroe Islands.,Department of Medicine, The Faroese National Hospital, Tórshavn, Faroe Islands
| | - J Mortensen
- Department of Medicine, The Faroese National Hospital, Tórshavn, Faroe Islands.,Department of Clinical Physiology, Nuclear Medicine & PET, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - L Connolly
- Sport and Health Sciences, University of Exeter, Exeter, UK
| | - P Krustrup
- Sport and Health Sciences, University of Exeter, Exeter, UK.,Department of Sports Science and Clinical Biomechanics, SDU Sport and Health Sciences Cluster (SHSC), Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - M Mohr
- Faculty of Health Sciences, Centre of Health Science, University of the Faroe Islands, Tórshavn, Faroe Islands.,Department of Sports Science and Clinical Biomechanics, SDU Sport and Health Sciences Cluster (SHSC), Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.,Department of Food and Nutrition, and Sport Science, Center for Health and Human Performance, University of Gothenburg, Gothenburg, Sweden
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Saghir Z, Ashraf H, Pedersen J, Mortensen J. P3.13-011 Use of Volume Growth and Fluor-Deoxy-Glucose Positron Emission Tomography in Evaluating Indeterminate Lung Nodules in Lung Cancer Screening. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1746] [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: 10/18/2022]
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Bandak M, Jørgensen N, Juul A, Lauritsen J, Kier MGG, Mortensen MS, Oturai PS, Mortensen J, Hojman P, Helge JW, Daugaard G. Reproductive hormones and metabolic syndrome in 24 testicular cancer survivors and their biological brothers. Andrology 2017; 5:718-724. [PMID: 28598554 DOI: 10.1111/andr.12355] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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: 12/16/2016] [Revised: 01/30/2017] [Accepted: 02/07/2017] [Indexed: 01/22/2023]
Abstract
Testicular cancer survivors have impaired gonadal function and increased risk of metabolic syndrome when compared to healthy controls. However, because of the fetal etiology of testicular cancer, familial unrelated healthy men might not be an optimal control group. The objective of this study was to clarify if testicular cancer survivors have impaired gonadal function and increased risk of metabolic syndrome when compared to their biological brothers. A cross-sectional study of testicular cancer survivors (ClinicalTrials.gov number, NCT02240966) was conducted between 2014 and 2016. Of 158 testicular cancer survivors included, 24 had a biological brother who accepted to participate in the study. Serum levels of reproductive hormones and prevalence of metabolic syndrome according to International Diabetes Federation Criteria and National Cholesterol Education Program (Adult Treatment Panel III) criteria comprised the main outcome measures of the study. Median age was similar in testicular cancer survivors and their biological brothers [44 years (IQR 39-50) vs. 46 (40-53) years respectively (p = 0.1)]. In testicular cancer survivors, follow-up since treatment was 12 years (7-19). Serum levels of luteinizing hormone and follicle-stimulating hormone were elevated (p ≤ 0.001), while total testosterone, free testosterone, inhibin B and anti-Müllerian hormone were lower (p ≤ 0.001) in testicular cancer survivors than in their biological brothers. The prevalence of metabolic syndrome was similar and apart from HDL-cholesterol, which was lower in testicular cancer survivors (p = 0.01); there were no differences in the individual components of the metabolic syndrome between testicular cancer survivors and their brothers. In conclusion, gonadal function was impaired in testicular cancer survivors, while we did not detect any difference in the prevalence of metabolic syndrome between testicular cancer survivors and their biological brothers.
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Affiliation(s)
- M Bandak
- Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - N Jørgensen
- Department of Growth and Reproduction, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.,International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), University of Copenhagen, Copenhagen, Denmark
| | - A Juul
- Department of Growth and Reproduction, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.,International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), University of Copenhagen, Copenhagen, Denmark
| | - J Lauritsen
- Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - M G G Kier
- Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.,Unit of Survivorship, Danish Cancer Society Research Center, Danish Cancer Society, Copenhagen, Denmark
| | - M S Mortensen
- Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - P S Oturai
- Department of Clinical Physiology, Nuclear Medicine and PET, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - J Mortensen
- Department of Clinical Physiology, Nuclear Medicine and PET, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - P Hojman
- Centre of Physical Activity Research, Centre of Inflammation and Metabolism, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - J W Helge
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - G Daugaard
- Department of Oncology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
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Mortensen J, Clark AJ, Lange T, Andersen GS, Goldberg M, Ramlau-Hansen CH, Head J, Kivimäki M, Madsen IEH, Leineweber C, Lund R, Rugulies R, Zins M, Westerlund H, Rod NH. Informal caregiving as a risk factor for type 2 diabetes in individuals with favourable and unfavourable psychosocial work environments: A longitudinal multi-cohort study. Diabetes Metab 2017; 44:38-44. [PMID: 28527866 DOI: 10.1016/j.diabet.2017.04.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Revised: 03/09/2017] [Accepted: 04/14/2017] [Indexed: 11/18/2022]
Abstract
AIM To examine whether informal caregiving is associated with increased risk of type 2 diabetes (T2D), and whether job strain and social support at work modify the association. METHODS Individual participant's data were pooled from three cohort studies-the French GAZEL study, the Swedish Longitudinal Occupational Survey of Health (SLOSH) and the British Whitehall II study-a total of 21,243 study subjects. Informal caregiving was defined as unpaid care for a closely related person. Job strain was assessed using the demand-control model, and questions on co-worker and supervisor support were combined in a measure of social support at work. Incident T2D was ascertained using registry-based, clinically assessed and self-reported data. RESULTS A total of 1058 participants developed T2D during the up to 10 years of follow-up. Neither informal caregiving (OR: 1.09, 95% CI: 0.92-1.30) nor high job strain (OR: 1.04, 95% CI: 0.86-1.26) were associated with T2D risk, whereas low social support at work was a risk factor for T2D (OR: 1.18, 95% CI: 1.02-1.37). Also, informal caregivers who were also exposed to low social support at work were at higher risk of T2D (OR: 1.40, 95% CI: 1.08-1.82) compared with those who were not informal caregivers and had high social support at work (multiplicative test for interaction, P=0.04; additive test for interaction, synergy index=10). CONCLUSION Informal caregiving was not independently associated with T2D risk. However, low social support at work was a risk factor, and informal caregivers with low social support at work had even higher risks of T2D.
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Affiliation(s)
- J Mortensen
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
| | - A J Clark
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - T Lange
- Department of Biostatistics, University of Copenhagen, Copenhagen, Denmark; Center for Statistical Science, Peking University, Peking, China
| | - G S Andersen
- Clinical Epidemiology, Steno Diabetes Center, Gentofte, Denmark
| | - M Goldberg
- Paris Descartes University, Paris, France; INSERM, Population-based Epidemiological Cohorts Unit-UMS 11, Paris, France
| | - C H Ramlau-Hansen
- Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, Denmark
| | - J Head
- Department of Epidemiology and Public Health, University College London, London, UK
| | - M Kivimäki
- Department of Epidemiology and Public Health, University College London, London, UK
| | - I E H Madsen
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - C Leineweber
- Division of Epidemiology, Stress Research Institute, Stockholm University, Stockholm, Sweden
| | - R Lund
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark; Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark
| | - R Rugulies
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - M Zins
- INSERM, Population-based Epidemiological Cohorts Unit-UMS 11, Paris, France; INSERM, UMR 1168, VIMA, Villejuif, France
| | - H Westerlund
- Division of Epidemiology, Stress Research Institute, Stockholm University, Stockholm, Sweden
| | - N H Rod
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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13
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Keizman D, Fosboel MO, Reichegger H, Peer A, Rosenbaum E, Desax MC, Neiman V, Petersen PM, Mueller J, Cathomas R, Gottfried M, Dresler H, Sarid D, Mermershtain W, Rouvinov K, Mortensen J, Gillessen S, Daugaard G, Omlin A. Imaging response during therapy with radium-223 for castration-resistant prostate cancer with bone metastases—analysis of an international multicenter database. Prostate Cancer Prostatic Dis 2017; 20:289-293. [DOI: 10.1038/pcan.2017.6] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Revised: 12/12/2016] [Accepted: 12/20/2016] [Indexed: 11/09/2022]
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Krustrup P, Skoradal MB, Randers MB, Weihe P, Uth J, Mortensen J, Mohr M. Broad-spectrum health improvements with one year of soccer training in inactive mildly hypertensive middle-aged women. Scand J Med Sci Sports 2017; 27:1893-1901. [PMID: 28124381 DOI: 10.1111/sms.12829] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/05/2016] [Indexed: 01/06/2023]
Abstract
The study tested the hypothesis that long-term soccer training has positive impact on cardiovascular profile, body composition, bone health, and physical capacity in inactive, pre-menopausal women with mild hypertension. The study applied a randomized controlled design in which physically inactive middle-aged women were separated into a soccer training group (n=19; SOC) and a control group (n=12; CON). SOC performed 128±29 (±SD) one-h small-sided soccer training sessions over one year. Blood pressure, body composition, blood lipid profile, and fitness level were determined pre- and post-intervention. Over one year, mean arterial pressure decreased more in SOC than in CON (-5±7 vs +4±5 mmHg; P<.05). Total-body fat mass decreased more (P<.05) in SOC than in CON (-2.5±2.5 vs +0.6±3.2 kg; P<.05), while the change scores for lean body mass were not significantly different in SOC (2.6±2.7 kg) compared to CON (1.1±1.9 kg, P=.09). Over one year, change scores in whole-body bone mineral density (0.004±0.032 vs -0.019±0.026 g·cm2 ) as well as bone mineral content (30±70 vs -39±113 g) were positive in SOC compared to CON (P<.05). Post-intervention plasma triglycerides decreased more (-0.1±0.7 vs +0.2±0.2 mmol·L-1 ) and HDL cholesterol increased more (0.2±0.7 vs -0.2±0.2 mmol·L-1 ) in SOC than in CON (P<.05). Yo-Yo intermittent endurance level 1 (122±105 vs 2±21%) and 20-m sprint performance (6±6 vs -1±2%) increased more (P<.05) in SOC than in CON. In conclusion, long-term soccer training resulted in broad-spectrum improvements in the health profile of untrained, pre-menopausal women with mild hypertension, including cardiovascular, metabolic, and musculo-skeletal benefits.
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Affiliation(s)
- P Krustrup
- Department of Sports Science and Clinical Biomechanics, SDU Sport and Health Sciences Cluster (SHSC), University of Southern Denmark, Odense M, Denmark.,Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, UK
| | - M-B Skoradal
- Centre of Health Sciences, Faculty of Natural and Health Sciences, University of the Faroe Islands, Tórshavn, Faroe Islands
| | - M B Randers
- Department of Sports Science and Clinical Biomechanics, SDU Sport and Health Sciences Cluster (SHSC), University of Southern Denmark, Odense M, Denmark
| | - P Weihe
- Centre of Health Sciences, Faculty of Natural and Health Sciences, University of the Faroe Islands, Tórshavn, Faroe Islands.,Department of Occupational Medicine and Public Health, The Faroese Hospital System, Tórshavn, Faroe Islands
| | - J Uth
- Department of Sports Science and Clinical Biomechanics, SDU Sport and Health Sciences Cluster (SHSC), University of Southern Denmark, Odense M, Denmark.,University Hospitals Centre for Health Research (UCSF), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - J Mortensen
- Department of Medicine, The Faroese National Hospital, Tórshavn, Faroe Islands.,Department of Clinical Physiology, Nuclear Medicine & PET, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - M Mohr
- Centre of Health Sciences, Faculty of Natural and Health Sciences, University of the Faroe Islands, Tórshavn, Faroe Islands.,Center of Health and Human Performance, Department of Food and Nutrition, and Sport Science, University of Gothenburg, Gothenburg, Sweden
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15
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Mistry A, Mortensen J. Consumer Use of the Nutrition Facts Panel versus Front-of-Package Labeling. J Acad Nutr Diet 2015. [DOI: 10.1016/j.jand.2015.06.283] [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: 10/23/2022]
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16
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Jensen AS, Idorn L, Thomsen C, von der Recke P, Mortensen J, Sørensen KE, Thilén U, Nagy E, Kofoed KF, Ostrowski SR, Søndergaard L. Prevalence of cerebral and pulmonary thrombosis in patients with cyanotic congenital heart disease. Heart 2015; 101:1540-6. [DOI: 10.1136/heartjnl-2015-307657] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Accepted: 05/04/2015] [Indexed: 11/04/2022] Open
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Frøkiaer J, Knudsen L, Mortensen J, Djurhuus JC, Jensen FT. The impact of different urinary flow rates on renoscintigraphy. Contrib Nephrol 2015; 79:74-6. [PMID: 2225871 DOI: 10.1159/000418154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- J Frøkiaer
- Institute of Experimental Clinical Research, University of Aarhus, Denmark
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Mohr M, Lindenskov A, Holm PM, Nielsen HP, Mortensen J, Weihe P, Krustrup P. Football training improves cardiovascular health profile in sedentary, premenopausal hypertensive women. Scand J Med Sci Sports 2015; 24 Suppl 1:36-42. [PMID: 24944131 DOI: 10.1111/sms.12278] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2014] [Indexed: 11/27/2022]
Abstract
The present study examined the effects of short-term recreational football training on blood pressure (BP), fat mass, and fitness in sedentary, 35-50-year-old premenopausal women with mild hypertension. Forty-one untrained, hypertensive women were randomized into a football training group (n = 21; FTG) and a control group (n = 20; CON). FTG performed 45 ± 1 1-h small-sided football training sessions during the 15-week intervention period. BP, body composition (dual-energy x-ray absorptiometry), blood lipid profile, and fitness level were determined pre- and post-intervention. After 15 weeks, systolic and diastolic BP, respectively, were lowered more (P < 0.05) in FTG (-12 ± 3 and -6 ± 2 mmHg) than in CON (-1 ± 1 and 1 ± 2 mmHg). Total body fat mass decreased more (P < 0.05) in FTG than in CON during the 15-week intervention period (-2.3 ± 0.5 kg vs 0.4 ± 0.3 kg). After 15 weeks, both total cholesterol (-0.4 ± 0.1 mmol/L vs 0.1 ± 0.2 mmol/L) and triglyceride (-0.2 ± 0.1 mmol/L vs 0.3 ± 0.2 mmol/L) were lowered more (P < 0.05) in FTG than in CON. Yo-Yo intermittent endurance level 1 test performance increased more (P < 0.05) in FTG than in CON (111 ± 18% vs 1 ± 3%) during the 15-week intervention period. In conclusion, short-term football training resulted in a marked reduction in BP and induced multiple improvements in fitness and cardiovascular health profile of untrained, premenopausal women with mild hypertension.
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Affiliation(s)
- M Mohr
- Sport and Health Sciences, College of Life and Environmental Sciences, St. Luke's Campus, University of Exeter, Exeter, UK; Department of Food and Nutrition, and Sport Sciences, University of Gothenburg, Gothenburg, Sweden; Faculty of Natural and Health Sciences, University of the Faroe Islands, Torshavn, Faroe Islands
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Danielsen AK, Christensen BM, Mortensen J, Voergaard LL, Herlufsen P, Balleby L. Establishment of a regional Danish database for patients with a stoma. Colorectal Dis 2015; 17:O27-33. [PMID: 25418604 DOI: 10.1111/codi.12848] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2014] [Accepted: 10/15/2014] [Indexed: 12/08/2022]
Abstract
AIM To present the Danish Stoma Database Capital Region with clinical variables related to stoma creation including colostomy, ileostomy and urostomy. METHOD The stomatherapists in the Capital Region of Denmark developed a database covering patient identifiers, interventions, conditions, short-term outcome, long-term outcome and known major confounders. The completeness of data was validated against the Danish National Patient Register. RESULTS In 2013, five hospitals included data from 1123 patients who were registered during the year. The types of stomas formed from 2007 to 2013 showed a variation reflecting the subspecialization and surgical techniques in the centres. Between 92 and 94% of patients agreed to participate in the standard programme aimed at handling of the stoma and more than 88% of patients having planned surgery had the stoma site marked pre-operatively. CONCLUSION The database is fully operational with high data completeness and with data about patients with a stoma from before surgery up to 12 months after surgery. The database provides a solid basis for professional learning, clinical research and benchmarking.
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Affiliation(s)
- A K Danielsen
- Department of Gastroenterology, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark
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Yasuda G, Kinguchi S, Katsumata M, Hirawa N, Shibata K, Van Roeyen CRC, Drescher A, Hess K, Boor P, Martin IV, Zok S, Braun G, Kuppe C, Liehn E, Weiskirchen R, Eriksson U, Gross O, Floege J, Eitner F, Ostendorf T, Mose FH, Jensen JM, Therwani S, Mortensen J, Hansen AB, Bech JN, Pedersen EB, Vink EE, De Boer A, Hoogduin JM, Leiner T, Bots ML, Blankestijn PJ, Silva Sousa H, Branco P, Dores H, Carvalho MS, Goncalves P, Almeida MS, Andrade MJ, Pereira M, Gaspar MA, Mendes M, Barata JD. HYPERTENSION: EXPERIMENTAL. Nephrol Dial Transplant 2014. [DOI: 10.1093/ndt/gfu137] [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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Abstract
The aim of this study was to test the precision and reliability of measurements of the bone mineral density (BMD) of the trapezium in patients with osteoarthritic trapeziometacarpal joints using dual-energy X-ray absorptiometry scans and to assess whether there is an acceptable correlation between the BMD of the trapezium and that of the distal radius, for which normative data exist. We included 66 patients (52 women, 14 men) diagnosed with Eaton-Glickel stage II-IV osteoarthritis and a mean age of 59 years (range 40-77) in a prospective study. We found good intra- and inter-observer agreement of BMD measurements. Reliability was also good in repeated measurements. There was an indication of an increase in BMD with progression in the Eaton-Glickel stage. There was only a moderate correlation between the BMD of the trapezium and that of the radius.
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Affiliation(s)
- T B Hansen
- Section of Hand Surgery, Department of Orthopaedics and Orthopaedic Research Unit, Regional Hospital Holstebro, Denmark
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Lund P, Sangild PT, Aunsholt L, Hartmann B, Holst JJ, Mortensen J, Mortensen PB, Jeppesen PB. Randomised controlled trial of colostrum to improve intestinal function in patients with short bowel syndrome. Eur J Clin Nutr 2012; 66:1059-65. [PMID: 22828734 DOI: 10.1038/ejcn.2012.93] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND/OBJECTIVES Colostrum is rich in immunoregulatory, antimicrobial and trophic components supporting intestinal development and function in newborns. We assessed whether bovine colostrum could enhance intestinal adaptation and function in adult short bowel syndrome (SBS) patients. SUBJECTS/METHODS Twelve SBS patients in this randomised cross-over study received 4 weeks oral supplement of bovine colostrum or an iso-energetic and iso-proteinaceous control (2.4 MJ/d, 500 ml/day) separated by a 4-week washout period. Patients were admitted four times for 72-h periods of fluid, electrolyte and nutrient balance studies. Meals, faeces and urine were weighed, and energy, macronutrient and electrolyte contents were analysed to calculate net nutrient uptake. Body composition was measured by dual-energy X-ray absorptiometry scans, and functional tests of handgrip strength and lung functions were performed. Eight patients completed the study and were included in the analysis. RESULTS Both supplements (colostrum and control) not only increased protein (0.96 ± 0.42 MJ/d, P=0.004 1.03 ± 0.44 MJ/d, P=0.003) and energy (1.46 ± 1.02 MJ/d, P=0.005, 1.76 ± 1.46 MJ/d, P=0.01) absorption but also absolute faecal wet weight excretions (231 ± 248 g/d, P=0.002, 319 ± 299 g/d, P=0.03), compared with baseline measurements. Both supplements improved handgrip strength (P=0.03) while only the control supplement increased lean body mass (1.12 ± 1.33 kg, P<0.049). Colostrum was not found to be superior to the control. CONCLUSION Intake of high-protein milk supplements increased net nutrient absorption for adult SBS patients, but at the expense of increased diarrhoea. Despite high contents of bioactive factors, colostrum did not significantly improve intestinal absorption, body composition or functional tests compared with the control.
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Affiliation(s)
- P Lund
- Department of Gastroenterology CA-2121, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
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Andersen K, Iversen M, Kjaergaard J, Mortensen J, Nielsen-Kudsk JE, Bendstrup E, Videbaek R, Carlsen J. 823 Impact of Pulmonary Venous Hypertension on Prognosis and Outcome after Lung Transplantation for End-Stage Chronic Obstructive Pulmonary Disease. J Heart Lung Transplant 2012. [DOI: 10.1016/j.healun.2012.01.840] [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: 10/28/2022] Open
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Fischer BM, Mortensen J, Hojgaard L. Authors' response. Thorax 2011. [DOI: 10.1136/thoraxjnl-2011-200654] [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: 11/03/2022]
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25
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Petersen AMW, Penkowa M, Iversen M, Frydelund-Larsen L, Andersen JL, Mortensen J, Lange P, Pedersen BK. Erratum to: Elevated Levels of IL-18 in Plasma and Skeletal Muscle in Chronic Obstructive Pulmonary Disease. Lung 2011. [DOI: 10.1007/s00408-011-9330-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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Andersen K, Iversen M, Kjaergaard J, Mortensen J, Bendstrup E, Videbaek R, Carlsen J. 17 Prevalence and Predictors of Pulmonary Hypertension in End-Stage Chronic Obstructive Pulmonary Disease. J Heart Lung Transplant 2011. [DOI: 10.1016/j.healun.2011.01.024] [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: 10/18/2022] Open
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Mortensen J, Lennert K, Bendtsen J, Rysgaard S. Heat sources for glacial melt in a sub-Arctic fjord (Godthåbsfjord) in contact with the Greenland Ice Sheet. ACTA ACUST UNITED AC 2011. [DOI: 10.1029/2010jc006528] [Citation(s) in RCA: 143] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Ashraf H, Dirksen A, Loft A, Bertelsen AK, Bach KS, Hansen H, Pedersen JH, Mortensen J. Combined use of positron emission tomography and volume doubling time in lung cancer screening with low-dose CT scanning. Thorax 2010; 66:315-9. [DOI: 10.1136/thx.2010.136747] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Alkureishi LWT, Burak Z, Alvarez JA, Ballinger J, Bilde A, Britten AJ, Calabrese L, Chiesa C, Chiti A, de Bree R, Gray HW, Hunter K, Kovacs AF, Lassmann M, Leemans CR, Mamelle G, McGurk M, Mortensen J, Poli T, Shoaib T, Sloan P, Sorensen JA, Stoeckli SJ, Thomsen JB, Trifiro G, Werner J, Ross GL. Joint Practice Guidelines for Radionuclide Lymphoscintigraphy for Sentinel Node Localization in Oral/Oropharyngeal Squamous Cell Carcinoma. Ann Surg Oncol 2009; 16:3190-210. [PMID: 19795174 PMCID: PMC2766455 DOI: 10.1245/s10434-009-0726-8] [Citation(s) in RCA: 81] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2009] [Indexed: 02/06/2023]
Abstract
Involvement of the cervical lymph nodes is the most important prognostic factor for patients with oral/oropharyngeal squamous cell carcinoma (OSCC), and the decision of whether to electively treat patients with clinically negative necks remains a controversial topic. Sentinel node biopsy (SNB) provides a minimally invasive method for determining the disease status of the cervical node basin, without the need for a formal neck dissection. This technique potentially improves the accuracy of histologic nodal staging and avoids overtreating three-quarters of this patient population, minimizing associated morbidity. The technique has been validated for patients with OSCC, and larger-scale studies are in progress to determine its exact role in the management of this patient population. This document is designed to outline the current best practice guidelines for the provision of SNB in patients with early-stage OSCC, and to provide a framework for the currently evolving recommendations for its use. Preparation of this guideline was carried out by a multidisciplinary surgical/nuclear medicine/pathology expert panel under the joint auspices of the European Association of Nuclear Medicine (EANM) Oncology Committee and the Sentinel European Node Trial (SENT) Committee.
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Affiliation(s)
- L W T Alkureishi
- Department of Plastic Surgery, University of Chicago Medical Center, Chicago, USA.
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Abstract
All 515 patients notified for tuberculosis for the first time in 1972, 1977 and 1982 in Copenhagen have been studied. Changes during the period and differences between Danes and immigrants were looked for. The percentage of immigrants increased during the period. The immigrants had a different age distribution, higher frequency of extrapulmonary tuberculosis with a distribution different from that of Danes, fewer complicating diseases and they drank less alcohol. No significant changes in the patient population took place in the decade studied, except for a decreasing number of Danes with tuberculosis, a decreasing number of abacillary patients and an increase in the percentage of extrapulmonary tuberculosis. At follow-up in 1983, none of the immigrants, but 147 of 407 Danes had died, mainly from complicating diseases. Life expectancy for the Danes, who survived the initial phase, was not significantly different from that for the population at large. None of the patients were bacillary at the time of the follow-up.
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Larsen S, Vilmann P, Krasnik K, Dirksen A, Clementsen P, Skov BG, Jacobsen GK, Lassen U, Eigtved A, Berthelsen AK, Mortensen J, Hoejgaard L. A comparison of endoscopic ultrasound guided biopsy and positron emission tomography with integrated computed tomography in lung cancer staging. Curr Health Sci J 2009; 35:5-12. [PMID: 24778810 PMCID: PMC3945239] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2008] [Accepted: 01/27/2009] [Indexed: 11/17/2022]
Abstract
BACKGROUND AND STUDY AIMS Exact staging of patients with non-small-cell lung cancer (NSCLC) is important to improve selection of resectable and curable patients for surgery. Positron emission tomography with integrated computed tomography (PET/CT) and endoscopic ultrasound guided fine needle aspiration biopsy (EUS-FNA) are new and promising methods, but indications in lung cancer staging are controversial. Only few studies have compared the 2 methods. The aim of this study was to assess and compare the diagnostic values of PET/CT and EUS-FNA for diagnosing advanced lung cancer in patients, who had both procedures performed. PATIENTS AND METHODS 27 patients considered to be potential candidates for resection of NSCLC underwent PET/CT and EUS-FNA. Diagnoses were confirmed either by open thoracotomy, mediastinoscopy or clinical follow-up. Advanced lung cancer was defined as tumour-stage ≥ IIIA(N2), corresponding to T4- and/or N2-N3- and/or M1 disease. Diagnostic values of PET/CT and EUS-FNA, with regard to the diagnosis of advanced lung cancer, were assessed and compared. RESULTS The sensitivity of PET/CT and EUS-FNA were respectively 60% and 60% for T4 disease, 56% versus 100% for N2-N3 disease (p=0.12) and 100% versus 33% for M1 disease (p=0.50). For diagnosing advanced lung cancer PET/CT had a sensitivity of 79%, specificity of 61%, positive predictive value (PPV) of 69%, negative predictive value (NPV) of 73%, and an accuracy of 70%. EUS-FNA had a sensitivity of 79%, specificity of 100%, PPV of 100%, NPV of 81%, and an accuracy of 89% for advanced lung cancer. CONCLUSIONS PET/CT and EUS-FNA had a comparable sensitivity and NPV for diagnosing advanced lung cancer, but EUS-FNA had superior specificity and PPV. The two methods seem to complement each other.
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Affiliation(s)
- S.S. Larsen
- Department of Surgical Gastroenterology, Gentofte University Hospital, Copenhagen, Denmark
| | - P. Vilmann
- Department of Surgical Gastroenterology, Gentofte University Hospital, Copenhagen, Denmark
| | - K. Krasnik
- Department of Cardio-Thoracic Surgery, Gentofte University Hospital, Copenhagen, Denmark
| | - Asger Dirksen
- Department of Pulmonology, Gentofte University Hospital, Copenhagen, Denmark
| | - P. Clementsen
- Department of Pulmonology, Gentofte University Hospital, Copenhagen, Denmark
| | - Birgit G. Skov
- Department of Pathology, Gentofte University Hospital, Copenhagen, Denmark
| | | | - U. Lassen
- Department of Oncology, Rigshospitalet, Copenhagen, Denmark
| | - Annika Eigtved
- PET & Cyclotron Unit, Rigshospitalet, Copenhagen, Denmark
| | | | - J. Mortensen
- Department of Clinical Physiology, Rigshospitalet, Copenhagen, Denmark
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Burton CM, Iversen M, Carlsen J, Andersen C, Mortensen J. The effect of baseline lung function on the determination of time to bronchiolitis obliterans syndrome. Eur Respir Rev 2008. [DOI: 10.1183/09059180.00010814] [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: 11/05/2022] Open
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Jung HU, Jakobsen JS, Mortensen J, Osther PJ, Djurhuus JC. Irrigation with isoproterenol diminishes increases in pelvic pressure without side-effects during ureterorenoscopy: a randomized controlled study in a porcine model. ACTA ACUST UNITED AC 2007; 42:7-11. [PMID: 17853047 DOI: 10.1080/00365590701520073] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Recently, we showed that endoluminally administered isoproterenol (ISO) inhibits muscle function of the pyeloureter in swine. This may be of value in managing increases in pelvic pressure during upper urinary tract endoscopy. The purpose of this study was to examine the effect of endoluminally administered ISO on increases in pelvic pressure and cardiovascular function during flexible ureterorenoscopy. MATERIAL AND METHODS The study was performed in anaesthetized female pigs. In terms of endoscopic procedures, the pigs were randomized as follows: Group 1, irrigation with 0.1 microg/ml ISO added to saline (n=12); and Group 2, irrigation with saline (n=10). A 5-Fr catheter was retrogradely placed in the renal pelvis and an 8-Fr catheter in the bladder for pressure measurements. Flexible ureterorenoscopy was performed with constant irrigation at a perfusion rate of 8 ml/min. Pelvic, bladder and blood pressure and heart rate were registered continuously. RESULTS Mean baseline pelvic pressure was identical in both groups: 12+/-2.3 mmHg in Group 1 and 14+/-3.6 mmHg in Group 2 (p=0.26). During ureterorenoscopy, mean pelvic pressure increased to 26+/-2.3 mmHg in Group 1 and to 38+/-3.1 mmHg in Group 2. Hence ISO reduced the pressure increase due to ureterorenoscopy by 42% (p<0.001). Pelvic pressure seemed to be independent of bladder pressure, which showed no difference between the two groups (p=0.067). Blood pressure and heart rate showed no significant differences between the two groups: p=0.425 and p=0.166, respectively. CONCLUSIONS ISO (0.1 microg/ml) added to irrigation fluid significantly reduces the increase in pelvic pressure during ureterorenoscopy in pigs, without concomitant side-effects.
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Affiliation(s)
- H U Jung
- Departments of Urology, Fredericia and Kolding Hospitals, Dronningensgade 97, Fredericia, Denmark.
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Jakobsen JS, Holst U, Jakobsen P, Steen W, Mortensen J. Local and systemic effects of endoluminal pelvic perfusion of isoproterenol: a dose response investigation in pigs. J Urol 2007; 177:1934-8. [PMID: 17437851 DOI: 10.1016/j.juro.2007.01.020] [Citation(s) in RCA: 10] [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] [Subscribe] [Scholar Register] [Received: 07/02/2006] [Indexed: 10/23/2022]
Abstract
PURPOSE Isoproterenol (Sygehus Apotekerne Danmark, Copenhagen, Denmark) is a beta-adrenergic agonist known to cause upper urinary tract relaxation. We studied the local effect on pelvic pressure and the systemic effects of endoluminal perfusion with isoproterenol in a porcine model. MATERIALS AND METHODS Pigs weighing 40 kg were studied. Catheters were placed in the renal pelvis for pressure measurement and perfusion, and a catheter was used to drain the bladder. Blood pressure and heart rate were recorded. In 6 pigs in group 1 the pelvic pressure increase was examined at increasing flow rates of 0, 2, 5, 8, 10 and 15 ml per minute with saline containing 0, 10(-3), 10(-2), 10(-1), 1 and 10 microg/ml isoproterenol. Blood values of isoproterenol were analyzed. In 6 pigs in group 2 the pelvis was perfused at a flow rate of 8 ml per minute with saline containing 0, 10(-5), 10(-4), 10(-3), 10(-2), 10(-1), 1 and 10 microg/ml isoproterenol. RESULTS In group 1 endoluminal perfusion with isoproterenol inhibited the pelvic pressure increase due to perfusion at all concentrations of isoproterenol. At a perfusion rate of 8 ml per minute the maximal effect (a 78% decrease) was achieved using 0.1 microg/ml isoproterenol without cardiovascular side effects. In group 2 all isoproterenol concentrations caused significant inhibition of the pressure-flow relationship in a dose dependent matter. A 64% decrease in the pressure increase due to saline perfusion was achieved at 0.1 microg/ml isoproterenol without concomitant significant cardiovascular side effects. Isoproterenol was only detected in plasma during perfusion with 1 and 10 microg/ml isoproterenol, which caused significant cardiovascular side effects in the latter case. CONCLUSIONS Isoproterenol significantly inhibits the pressure increase due to perfusion in the normal porcine renal pelvis without concomitant cardiovascular side effects. Isoproterenol is a safe drug in this porcine model and, hence, it is potentially useful during endourological procedures.
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Affiliation(s)
- J S Jakobsen
- Department of Urology L, Odense University Hospital, Odense, Denmark.
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Petersen AMW, Penkowa M, Iversen M, Frydelund-Larsen L, Andersen JL, Mortensen J, Lange P, Pedersen BK. Elevated levels of IL-18 in plasma and skeletal muscle in chronic obstructive pulmonary disease. Lung 2007; 185:161-71. [PMID: 17436040 DOI: 10.1007/s00408-007-9000-7] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2007] [Indexed: 11/26/2022]
Abstract
The aim of this study was to test the hypothesis that systemic inflammation in patients with chronic obstructive pulmonary disease (COPD) is accompanied by enhanced interleukin 18 (IL-18) expression in skeletal muscle, which may precede muscle weight loss. Twenty patients with moderate to severe COPD [12 women, 66 +/- 9.4 years of age and forced expiratory volume in 1 second (FEV(1)) of 32% +/- 12 % of predicted value] and 20 healthy age-, gender-, and body mass index (BMI)-matched controls (10 nonsymptomatic smokers and 10 nonsmokers) were included in the study. Plasma levels of IL-18 were elevated in COPD patients (n = 20) versus healthy controls (n = 20) (221.2 pg/ml [196.0-294.2 pg/pl] vs. 164.8 pg/ml [144.4-193.3 pg/pl], p = 0.05) [corrected] and IL-18 was expressed in skeletal muscle, with IL-18 mRNA levels being elevated in biopsies from COPD patients (n = 19) versus healthy controls (n = 18) (4.3 [2.6-5.9] vs. 2.4 [1.6-3.1], p = 0.05) [corrected]. Immunohistochemical evaluation revealed a strong expression of IL-18 in Type II muscle fibers from COPD patients. Plasma levels and skeletal muscle mRNA levels of tumor necrosis factor alpha (TNF-alpha) and IL-6 did not differ between the groups. Elevated skeletal muscle expression of IL-18 was found in COPD patients with normal body weight, indicating that IL-18 potentially may be involved in the pathogenesis of COPD-associated muscle wasting.
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Affiliation(s)
- A M W Petersen
- The Centre of Inflammation and Metabolism, Department of Infectious Diseases, The Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
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Voergaard LL, Vendelbo G, Carlsen B, Jacobsen L, Nissen B, Mortensen J, Hansen G, Bach K, Baech SB. Ostomy bag management: comparative study of a new one-piece closed bag. ACTA ACUST UNITED AC 2007; 16:95-6, 98-101. [PMID: 17353819 DOI: 10.12968/bjon.2007.16.2.22767] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [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: 11/11/2022]
Abstract
The aim of this study was to compare the performance of a new one-piece closed ostomy bag, SenSura, to an already established bag with a focus on minimizing problems related to use of stoma bags for individuals with a colostomy. There were 68 Danish participants with a colostomy who tested each bag for 1 week in a randomized, open, comparative, crossover study. The SenSura bag was perceived more secure than the reference bag (p=0.0006). Crucial performance and safety parameters were rated significantly better for SenSura than for the reference bag. The high preference for SenSura (85%) reflected these results (p<0.0001). Individuals with a colostomy can expect a higher sense of security with the SenSura bag than with the reference bag. This may relate to good adhesion, tack, flexibility and effective filter performance. Future studies should examine the long-term effects of SenSura on peristomal skin conditions. To our knowledge, this is the first published comparative study of one-piece closed ostomy bags.
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Affiliation(s)
- L L Voergaard
- Surgical Unit, Surgical Clinic, Hillerød Hospital, Denmark
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37
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Fischer BM, Mortensen J, Langer SW, Loft A, Berthelsen AK, Petersen BI, Daugaard G, Lassen U, Hansen HH. A prospective study of PET/CT in initial staging of small-cell lung cancer: comparison with CT, bone scintigraphy and bone marrow analysis. Ann Oncol 2006; 18:338-45. [PMID: 17060487 DOI: 10.1093/annonc/mdl374] [Citation(s) in RCA: 105] [Impact Index Per Article: 5.8] [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: 11/14/2022] Open
Abstract
BACKGROUND Small-cell lung cancer (SCLC) accounts for 15%-20% of all lung cancer cases. Accurate and fast staging is mandatory when choosing treatment, but current staging procedures are time consuming and lack sensitivity. PATIENTS AND METHODS A prospective study was designed to examine the role of combined positron emission tomography/computed tomography (PET/CT) compared with standard staging (CT, bone scintigraphy and immunocytochemical assessment of bone marrow biopsy) of patients with SCLC. Thirty-four consecutive patients were included. Twenty-nine patients received initial PET/CT. RESULTS PET/CT caused change of stage in 5/29 (17%). Excluding patients with unconfirmed findings or pleural effusion, the sensitivity for accurate staging of patients with extensive disease was the following: for standard staging 79%, PET 93% and PET/CT 93%. Specificity was 100%, 83% and 100%, respectively. CONCLUSION The results from this first study on PET/CT in SCLC indicates that PET/CT can simplify and perhaps even improve the accuracy of the current staging procedure in SCLC. A larger clinical trial, preferably with consequent histological confirmation in case of discordance, however, is warranted.
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Affiliation(s)
- B M Fischer
- Department of Nuclear Medicine and PET, Copenhagen University Hospital, Copenhagen, Denmark.
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Abstract
PURPOSE Previously, we have for the first time reported enlargement of the pig kidney during long-term ciclosporin (CsA) treatment. In this paper, we summarize our findings of renal enlargement during long-term protocols with various dosages and durations of CsA administration as well as discuss possible pathogenetic mechanisms. MATERIALS AND METHODS Twenty-two adolescent Gottingen minipigs were allocated into four groups: group A (n = 6) served as controls for 6 months; group B (n = 5) were treated with CsA (10 mg/kg per day) for 6 months, group C (n = 4), with CsA (20 mg/kg per day) for 6 months, and group D (n = 7) with CsA (10 mg/kg per day) orally for 12 months. At regular intervals, renal length and total volume were measured using magnetic resonance imaging; renal biopsies were performed for histological examination. RESULTS A significant increase in kidney volume occurred in all CsA-treated pigs (groups B, C, and D); whereas the volume remained stable in the control animals (group A). A small but significant rise in kidney length was observed in groups A, B, and C, probably due to the normal growth of the animals. Histological examination was normal after treatment with CsA doses of 10 and 20 mg/kg per day for 6 months but showed definite interstitial fibrosis and glomerulosclerosis after treatment with 10 mg/kg per day CsA for 12 months. CONCLUSION Long-term CsA treatment produced renal enlargement in pigs before the development of histological changes in the kidney. Thus, renal enlargement may represent an early stage of chronic CsA nephrotoxicity.
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Affiliation(s)
- D Cibulskyte
- Department of Renal Medicine, Skejby Sygehus, Aarhus University Hospital, Aarhus, Denmark
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Kristensen DH, Pedersen M, Grøn MC, Flyvbjerg A, Madsen M, Frøkiaer J, Mortensen J. Intrarenal blood oxygenation and renal function measured by magnetic resonance imaging during long-term cyclosporine treatment. Transplant Proc 2006; 37:3302-4. [PMID: 16298580 DOI: 10.1016/j.transproceed.2005.09.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [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: 10/25/2022]
Abstract
Treatment with cyclosporine (CsA) markedly affects the renin-angiotensin-aldosterone system in parallel with an increase in the net tubular reabsorption or a decrease in secretion. Since tubular reabsorption is closely linked to medullary oxygen consumption, the aim of the present study was to investigate the intrarenal oxygenation and renal function in response to CsA. Six mini Göttingen pigs were treated with CsA (10 mg/kg/d) for 6 months. The intrarenal oxygenation was indirectly measured as R2* obtained with a multiecho gradient-echo magnetic resonance imaging (MRI) sequence. Single-kidney renal blood flow (skRBF) was measured by a velocity-sensitive gradient-echo MRI sequence. Relative single-kidney glomerular filtration rate (rskGFR) was derived from the MRI time-activity curve in response to an intravenous bolus of Gd-DTPA (0.05 mmol/kg). The present study showed that administration of CsA increased the medullary R2* (23.1 Hz vs 19.0 Hz, P = .002), whereas R2* was slightly increased in the renal cortex (13.3 Hz vs 12.3 Hz, P = .012). In parallel, rskGFR increased significantly (47.2 mL/min vs 19.8 mL/min, P = .005) but skRBF was unchanged (197.6 mL/min vs 202.5 mL/min, P > .05). The increased R2* in the renal medulla indicated that CsA augments the tubular reabsorption of water, leading to increased oxygen consumption. The supply of oxygen to the kidney was, however, maintained during treatment with CsA as suggested by an unchanged renal blood flow. The increased tubular reabsorption was compensated for by an elevated glomerular filtration rate.
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Affiliation(s)
- D H Kristensen
- MR Research Center, Aarhus University Hospital, Skejby Sygehus, Brendstrupgårdsvej 100, DK-8200 Aarhus N, Denmark.
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40
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Abstract
Cyclosporine A (CsA) is one of the keystones in immunosuppressive treatment after solid organ transplantation, despite its major side effects such as nephrotoxicity. The chronic nephrotoxic effects of CsA seen in humans have been difficult to reproduce in small-animal models. The aim of the present study was to examine the chronic nephrotoxicity produced by therapeutic dosages of CsA in a pig model. Among 11 Gottingen minipigs included in the study, three died, yielding data from five animals given CsA (10 mg/kg/d, orally) for 6 months, and three controls. Body weight, blood pressure, glomerular filtration rate (GFR) by plasma clearance of (51)Cr-ethylenediamine-tetraacetic acid, CsA concentration, serum creatinine, and other values were measured every 5 weeks. Our results showed that the whole blood trough CsA levels were lower in pigs than in humans treated with similar CsA doses. Renal biopsies, which were obtained successfully, except one case of macroscopic hematuria, showed no histological changes in the kidney. No significant increase in serum creatinine or blood pressure was observed. Surprisingly, there was a significant increase in GFR during CsA treatment. We conclude that the pig model displays a hyperfiltration that warrants further investigation.
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Affiliation(s)
- D Cibulskyte
- Department of Renal Medicine, Aarhus University Hospital, Skejby Sygehus, Brendstrupgaardsvej 100, 8200 Aarhus N, Denmark.
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Grøn MC, Hanefelt Kristensen D, Cibulskyte D, Hørlyck A, Kaalund H, Hansen HE, Madsen M, Pedersen M, Mortensen J. Changes in renal dimensions evaluated by magnetic resonance imaging and ultrasonography during long-term ciclosporin-A treatment. Acta Radiol 2006; 47:58-64. [PMID: 16498934 DOI: 10.1080/02841850500406829] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [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: 10/25/2022]
Abstract
PURPOSE To investigate changes in renal dimensions during long-term treatment with ciclosporin-A (CsA). MATERIAL AND METHODS Five mini-Göttingen pigs were treated with CsA (10 mg kg(-1) day(-1)) for 6 months; 3 untreated animals served as controls. Renal length was measured by magnetic resonance imaging (MRI) and ultrasonography (US); renal volume by MRI. Examinations were performed at baseline (0 weeks) and after the start of CsA treatment at intervals of 5 weeks (5-25 weeks). RESULTS Comparison of baseline and end-point data (0 weeks vs. 25 weeks) revealed a statistically significant increase in renal volume in CsA-treated animals (87.1 cm3 vs. 55.9 cm3, P=0.002). Renal volume remained unchanged in the control group. A significant increase in renal length was found both in the CsA-treated pigs (MRI: 96 mm vs. 84 mm, P<0.001; US: 94 mm vs. 81 mm, P<0.001) and in the control group (MRI: 97 mm vs. 85 mm, P<0.001; US: 89 mm vs. 81 mm, P=0.018). No difference was found between MRI and US measurements based on 40 paired units (MRI variance: 2.4-30.3% and US variance: -5.1-40.6%, P=0.133). CONCLUSION During long-term CsA treatment, renal volume increases in mini-pigs, but there is no correlation between the increase in volume and the increase in length in this pig model.
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Affiliation(s)
- M C Grøn
- The Clinical Institute, Aarhus University Hospital, Skejby, Denmark
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42
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Rosendal F, Bjarkam CR, Larsen M, Hansen HE, Madsen M, Sørensen JC, Mortensen J. Does Chronic Low-Dose Treatment With Cyclosporine Influence the Brain? A Histopatological Study in Pigs. Transplant Proc 2005; 37:3305-8. [PMID: 16298581 DOI: 10.1016/j.transproceed.2005.09.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [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: 10/25/2022]
Abstract
Twenty percent of the patients immunosuppressed with cyclosporine A (CsA) develop neurological side effects such as tremor, paresthesias, headache, seizures, visual disorders, paresis, and coma-CsA encephalopathy. The encephalopathy resolves on CsA discharge; autopsies of recovered patients are normal. Characteristic lesions are seen on magnetic resonance imaging (MRI) during the period of encephalopathy. MRI of asymptomatic patients receiving CsA as well as most recovered patients are normal. Several theories of pathogenesis have been proposed, but none has been firmly established. The current placebo-controlled study, blinded to the investigator, was accordingly initiated to elucidate histopathological changes in the brain. Twelve adult Göttingen minipigs were randomized into two groups treated with either low-dose CsA (10 mg/kg/d) or no treatment for 6 months. Behavior, blood pressure, and blood parameters were measured throughout the study. All animals had a cerebral MRI before sacrifice. Three control pigs and one CsA-treated pig died during observation and were excluded from the study. None of the remaining eight pigs displayed behavioral signs or MRI-visible lesions characteristic of CsA encephalopathy. The brains appeared all normal on the gross pathological examination, but microscopy revealed perivascular, meningeal, and neuronal tissue infiltration with granulocytes and mononuclear cells in one CsA-treated pig, while the remaining pigs were without histopathological lesions. Pathological changes were noticed in one out of five CsA-treated animals, corresponding to the percentage of patients treated with CsA who develop CsA encephalopathy. To pursue this finding, two studies, one using CsA 20 mg/kg/d for 6 months and one using CsA 10 mg/kg/d for 12 months, have been initiated.
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Affiliation(s)
- F Rosendal
- Department of Neurobiology, Institute of Anatomy, University of Aarhus, 8000 Aarhus C, Denmark.
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43
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Komolov A, Møller P, Aliaev Y, Lazneva E, Akhremtchik S, Kamounah F, Mortensen J, Schaumburg K. Organic–organic interfaces and unoccupied electronic states of thin films of perylene and naphthalene derivatives. J Mol Struct 2005. [DOI: 10.1016/j.molstruc.2005.01.047] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Legin A, Kirsanov D, Rudnitskaya A, Iversen J, Seleznev B, Esbensen K, Mortensen J, Houmøller L, Vlasov Y. Multicomponent analysis of fermentation growth media using the electronic tongue (ET). Talanta 2004; 64:766-72. [DOI: 10.1016/j.talanta.2004.04.001] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2003] [Revised: 03/29/2004] [Accepted: 04/01/2004] [Indexed: 11/28/2022]
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Abstract
The aim of this study was to assess the value of fluorodeoxyglucose positron emission tomography (FDG PET) imaging of small pulmonary nodules incidentally detected by spiral computed tomography (CT) in a high-risk population. Ten patients (five females, five males, aged 54-72 years) were recruited from an ongoing 4-year placebo controlled intervention study of the effect of inhaled steroids in 300 smokers with moderate to severe chronic obstructive pulmonary disease. The participants received yearly CT scans of the chest. Patients with a negative chest radiograph at the time of inclusion, but with pulmonary nodules indeterminate for malignancy detected by conventional spiral CT on a subsequent scan, were referred for FDG PET. Histological diagnoses were sought for all nodules with FDG uptake or where CT showed that they had grown. Ten patients had pulmonary nodules indeterminate for malignancy (approx. 3.3% of the entire study population). The prevalence of malignancy in this group was 50%. The accuracy of PET was high, in spite of the fact that seven patients had nodules smaller than 15 mm and two patients had bronchoalveolar cell carcinoma. This small prospective study indicates that subsequent assessment with FDG PET of small pulmonary nodules incidentally detected by CT has the potential to minimize the numbers of invasive procedures performed in individuals with a benign pulmonary lesion. FDG PET also increases the possibility of an early diagnosis as compared to the strategy of watchful waiting.
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Affiliation(s)
- B M Fischer
- Department of Clinical Physiology and Nuclear Medicine, Diagnostic Centre, Rigshopitalet, Copenhagen, Denmark
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46
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Holst U, Mortensen J. The relation between pelvic pressure and bladder pressure during pelvic perfusion with standardized flow rates. APMIS Suppl 2003:13-7. [PMID: 12874942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
The aim of this study was to elucidate the relation between pelvic pressure and bladder pressure during pelvic perfusion with standardized flow rates. Anaesthetized Danish Landrace Breed pigs (n = 5) weighing 35-40 kg were studied. Transparenchymally two 6-F catheters were placed in both renal pelves for pressure measurement and perfusion. Transurethrally two catheters were placed in the bladder for pressure measurements and for urine collection and infusion. Bladder filling was done with a constant infusion rate of 45 ml/min during perfusion of both pelves with saline consecutively with the flow rates: 0, 2, 4, 6 and 8 ml/min during continuous measurement of bladder and bilateral pelvic pressure. The baseline diuresis varied from 0.4-1.0 ml/min. Without pelvic perfusion a negative pressure gradient between pelvis and bladder was seen demonstrating the importance of ureteral peristalsis. Pelvic perfusion with 2 ml/min showed that pelvic and bladder pressure were equal demonstrating weakening of ureteral peristalsis. During perfusion with higher flow rates pelvic pressure was higher than bladder pressure, showing that the positive gradient was important for urine transport. In conclusion ureteral peristalsis is important at low flow rates during increasing bladder pressure. At higher flow rates peristalsis weakens and the pressure gradient is the determining factor.
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Affiliation(s)
- U Holst
- Institute of Experimental Clinical Research, University of Aarhus, Aarhus, Denmark
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47
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Abstract
PURPOSE We evaluated the effects of norepinephrine on transport pressures in the normal upper urinary tract of the pig during increasing perfusion rates. MATERIALS AND METHODS Anesthetized Danish landrace Yorkshire pigs weighing 38 to 40 kg were studied. Transparenchymally 2, 6Fr catheters were introduced into the left renal pelvis for pressure measurements and perfusion, respectively. An ultrasonic flow probe was inserted around the left renal artery to record blood flow. A 10Fr catheter was placed transurethrally for bladder drainage and the bladder was maintained empty during the entire study. In the 5 group 1 pigs the pelvic pressure increase was examined at increasing perfusion rates of the renal pelvis (2, 4, 6, 8, 10 and 15 ml per minute) in response to endoluminal administration of increasing concentrations of norepinephrine (0, 5, 50 and 100 microg/ml) in saline. In the 5 group 2 pigs the pressure flow study was also done 4 times per animal using isotonic saline. RESULTS Endoluminal norepinephrine had a dose dependent effect on the pressure flow relationship. Perfusion with 5 and 50 microg/ml norepinephrine caused a delayed increase and a decrease in pelvic pressure in response to increasing flow rates, whereas perfusion with 100 microg/ml norepinephrine significantly inhibited and almost eliminated the pressure increase at all perfusion rates compared with saline perfusion. Importantly there were no changes in blood pressure, the heart rate or renal arterial blood flow. In group 2 perfusion with isotonic saline resulted in the same pressure response to increasing flow rates each time. CONCLUSIONS Endoluminal administration of norepinephrine caused a dose dependent inhibition on the pressure phases of the pressure flow relationship of the upper urinary tract in pigs. No systemic changes were observed. These observations may provide a useful adjuvant treatment strategy for upper urinary tract stone treatment and endoscopy.
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Affiliation(s)
- U Holst
- Department of Surgery, Haderslev Sygehus, Haderslev, Denmark
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Holst U, Tuckus G, Frokiaer J, Djurhuus JC, Mortensen J. Contralateral response in renal pelvic pressure and diuresis during increasing ipsilateral pelvic pressure and flow: a study of the normal and denervated upper urinary tract in pigs. BJU Int 2002; 90:742-7. [PMID: 12410759 DOI: 10.1046/j.1464-4096.2002.02994.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To examine, in young pigs, changes in baseline pelvic pressure and diuresis in the contralateral kidney during conditions of increasing pelvic pressure and perfusion with isotonic saline in the ipsilateral renal pelvis; the role of a reno-renal nervous mechanism was examined by denervating the kidneys, and the effect of bladder filling on these variables assessed. MATERIALS AND METHODS Female pigs (37-40 kg) were assessed under general anaesthesia. Transparenchymally, one 6 F and two 6 F catheters were introduced into the right and left renal pelvis, respectively. Through a bladder incision an 8 F catheter was introduced 10 cm into the right ureter to collect urine and the orifice closed around the catheter. For bladder drainage and to measure bladder pressure a 10 F catheter was placed in the bladder and both the 8 F and 10 F catheters lead out through the urethra. In group A, five animals served as controls, with group B comprising eight with intact nerves and group C eight with denervated kidneys. In group B and C the left renal pelvis was perfused with isotonic saline at 2, 4, 6, 8, 10, 12 and 16 mL/min while the bilateral pelvic pressure and right renal diuresis were recorded; the bladder was kept empty and 0.5 h later the left pelvis was perfused with 10 mL/min while the bladder catheter was closed. Perfusion continued until micturition occurred. The bilateral pelvic pressure, bladder pressure and right renal diuresis were recorded. In group C the kidneys were surgically denervated, dividing all adhesions and all connective tissue around the pelvis and the vascular pedicle. The renal artery was freed to the aortic level. RESULTS During the pressure-perfusion study the mean (sd) right pelvic pressure was 7.4 (0.2) mmHg in group B and 8.6 (0.2) mmHg in group C. The diuresis from the right kidney in both groups was similar and the same as that in group A. The perfusion rate and pressure on the left side had no influence on pelvic pressure and diuresis on the right side. During perfusion with a full bladder the right pelvic pressure was 8.6 mmHg in group B and 9.5 mmHg in group C. Diuresis in group B was approximately 0.6 mL/min and a little higher in group C, at approximately 1 mL/min, but identical to that in group A. CONCLUSION These results indicate that a reno-renal reflex mechanism has no apparent role in young pigs during pressure-perfusion measurements with an empty or full bladder.
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Affiliation(s)
- U Holst
- Surgical Department, Haderslev Sygehus, and Institute of Experimental Clinical Research, University of Aarhus, Denmark.
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49
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Abstract
Chylous effusion is an infrequent complication of abdominothoracic surgery. When conservative therapy cannot cure the patient, surgical closure of the thoracic duct must be performed. If radiological lymphography is impossible to perform, lymphoscintigraphy with Tc-99m human serum albumin is a good alternative. Here, we present two patients who developed chylothorax after abdominothoracic surgery. Successful surgery was performed after lymphoscintigraphy had demonstrated the disruption of the thoracic duct.
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Affiliation(s)
- T Stavngaard
- Department of Clinical Physiology and Nuclear Medicine, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
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50
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Rawashdeh YF, Hørlyck A, Djurhuus JC, Frokiaer J, Mortensen J. Resistive index: an experimental study of the effects of diuretic stimulation in the unobstructed porcine kidney. BJU Int 2002; 89:443-8. [PMID: 11872040 DOI: 10.1046/j.1464-4096.2001.01795.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To study the effects of diuretic stimulation with frusemide and mannitol on the renal resistive index (RI) of the undilated unobstructed porcine kidney. MATERIALS AND METHODS Experiments were carried out on 14 pigs divided into two equal groups (A and B), under general anaesthesia. In all pigs both ureters were catheterized, thereby allowing urine output to be measured on each side separately, and an indwelling catheter in a femoral artery used to continuously measure the systemic blood pressure. Furthermore, in five pigs from each group, right renal blood flow was measured by ultrasonic flow probes placed around the renal arteries. The right kidney RI was measured at baseline and at 5-min intervals after frusemide (group A) and mannitol (group B) stimulation, for 75 min. RESULTS Frusemide caused significant increases in diuresis (P < 0.001) and renal blood flow (P = 0.009). This was accompanied by a significant decrease in mean arterial pressure (P < 0.001). The RI was unaffected (P = 0.706), with mean values in group A of 0.58-0.65. Mannitol also caused a significant increase in diuresis (P < 0.001) and a subtle but significant decrease in mean arterial pressure (P < 0.001). However, renal blood flow was unaffected by the diuretic (P = 0.820); the mean RI values were unaffected, at 0.61-0.66 (P = 0.375). CONCLUSIONS These results show that diuretic stimulation with frusemide or mannitol does not affect the RI of the unobstructed undilated porcine kidney, despite significant changes in diuresis, renal blood flow and mean arterial pressure.
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Affiliation(s)
- Y F Rawashdeh
- Institute of Experimental Clinical Research, Aarhus University, Aarhus, Denmark.
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