Published in 1990

Advances in Pain research and Therapy Volume 17

Andersen, R. B., Jacobsen, S., Danneskiold-Samsøe, B. & Bartels, E. M. 1990 Advances in Pain research and Therapy Volume 17. Bind 296-76

Publikation: Forskning - peer reviewBidrag til bog/antologi

Originalsprog Engelsk
Titel Advances in Pain research and Therapy Volume 17
Vol/bind 296-76
Publikationsdato 1990
Status Udgivet - 1990

Migraeneauraen--karsygdom eller neuronsygdom?

Olsen, T. S., Friberg, L. & Lassen, N. A. 21 maj 1990 I : Ugeskrift for Laeger. 152, 21, s. 1507-9 3 s.

Publikation: Forskning - peer reviewTidsskriftartikel

During the migraine-aura cerebral blood flow (CBF) is reduced in areas corresponding to the neurological deficits and symptoms. Whether this CBF reduction is the primary cause of the neurological deficits (the vascular theory) or a secondary result of primary neuronal dysfunction in particular "spreading depression" (SD) (the neurogenic theory) is still under discussion. The latter theory is supported by CBF investigations performed during attacks of migraine with aura (MA). The CBF reduction was found to be modest (20-35%) and not sufficient to cause ischemia which usually demands reduction of CBF by more than 50%. In addition the low-flow area appeared to "spreading" in the same manner as that seen in SD in the rat ("spreading oligemia"). Recent studies indicate, however, that the CBF reduction in most cases, after all, is sufficient to cause ischemia and that "spreading oligemia" might be an artifact caused by "scattered radiation". Persistent neurological deficits, EEG abnormalities and infarcts on CT-scans are seen after MA, thus further supporting the theory of vascular dysfunction (vasospasm) and ischemia as the cause of the migraine-aura.
Originalsprog Dansk
Tidsskrift Ugeskrift for Laeger
Udgivelsesdato 21 maj 1990
Vol/bind 152
Tidsskriftsnummer 21
Sider 1507-9
Antal sider 3
ISSN 0041-5782
Status Udgivet
Serum concentrations of procollagen type III aminoterminal peptide have previously been reported to be low in some patients with primary fibromyalgia and the aim of this study was to determine if such patients differ clinically from primary fibromyalgia patients with normal levels of procollagen type III aminoterminal peptide. Subjective symptoms, tender points and dynamic muscle strength in 45 women with primary fibromyalgia were related to serum concentrations of procollagen type III aminoterminal peptide. Patients with low serum concentrations of procollagen type III aminoterminal peptide had more symptoms, a higher frequency of tender points and lesser quality of sleep compared to patients with normal serum concentrations of procollagen type III aminoterminal peptide (P less than 0.05). They also had a lower dynamic muscle strength (P less than 0.0005). We conclude that the serum concentrations of procollagen type III aminoterminal peptide of primary fibromyalgia patients are connected to the disease impact.
Originalsprog Engelsk
Tidsskrift British Journal of Rheumatology
Vol/bind 29
Tidsskriftsnummer 3
Sider (fra-til) 174-7
Antal sider 4
ISSN 0263-7103
Status Udgivet - jun. 1990
Primary fibromyalgia syndrome (PFS) is a non-articular rheumatic condition characterized by chronic muscular pain. We have performed screening for autoantibodies in 20 women with PFS and in 19 age-matched healthy women. Fifty-five percent of the PFS patients had anti-smooth muscle antibodies and 40% had anti-striated muscle antibodies. None of the control subjects had any muscle antibodies. There was no significant difference in frequency of the remaining autoantibodies between the groups investigated. The present study indicates autoimmune responses in PFS against antigens of the diseased tissue itself, a finding which may be secondary to the disease or have relevance to the still obscure pathogenesis of the syndrome.
Originalsprog Engelsk
Tidsskrift APMIS : acta pathologica, microbiologica, et immunologica Scandinavica
Vol/bind 98
Tidsskriftsnummer 7
Sider (fra-til) 655-8
Antal sider 4
ISSN 0903-4641
Status Udgivet - jul. 1990

Severe non-occlusive ischemic stroke in young heroid addicts

Jensen, R., Olsen, T. S. & Winther, B. B. 1990 I : Acta Neurologica Scandinavica. s. 354-7 4 s.

Publikation: Forskning - peer reviewTidsskriftartikel

Originalsprog Dansk
Tidsskrift Acta Neurologica Scandinavica
Sider (fra-til) 354-7
Antal sider 4
ISSN 0001-6314
Status Udgivet - 1990

Surecut 0.6 mm liver biopsy in the diagnosis of cirrhosis

Torp-Pedersen, S., Vyberg, M., Smith, E., Højgaard, L., Hansen, U., Stadeager, C., Schlichting, P., Juul, N. & Gluud, C. aug. 1990 I : Liver. 10, 4, s. 217-20 4 s.

Publikation: Forskning - peer reviewTidsskriftartikel

Liver biopsy with the 0.6 mm (23 gauge) Surecut needle was compared to conventional Menghini biopsy in the diagnosis of cirrhosis. Seventy-seven consecutive patients (mainly alcoholics) with a clinical indication for liver biopsy had both biopsies performed simultaneously. In 71 patients sufficient material for a morphological diagnosis concerning liver architecture was obtained with both biopsy techniques (Surecut insufficient in 5 cases and Menghini insufficient in 2 cases). The biopsies were classified as cirrhosis or non-cirrhosis. There was agreement in 69 cases (97%, confidence limits 90-100%). Using the result of the Menghini biopsy as the final diagnosis, the predictive values for a positive and negative diagnosis for the Surecut needle were 96% and 98%, respectively. There were no complications to either of the biopsies. It is suggested that the 0.6 mm Surecut biopsy may be used in the diagnosis of cirrhosis in cases where conventional Menghini needle biopsy is contraindicated.
Originalsprog Engelsk
Tidsskrift Liver
Vol/bind 10
Tidsskriftsnummer 4
Sider (fra-til) 217-20
Antal sider 4
ISSN 0106-9543
Status Udgivet - aug. 1990
Originalsprog Engelsk
Tidsskrift Annals of Neurology
Udgivelsesdato 1990
Sider 791-8
Antal sider 8
ISSN 0364-5134
Status Udgivet
Ten years of study has resulted in considerable but fragmented knowledge about regional cerebral blood flow in migraine with aura (classic migraine). In the present study, the number of repeatedly studied patients (n = 63) was large enough to determine statistically significant sequences of events and statistically significant spatial relations. The first observable event was a decrease of regional cerebral blood flow posteriorly in one cerebral hemisphere. Further development of this pathological process was accompanied by the aura symptoms. Thereafter headache occurred while regional cerebral blood flow remained decreased. During the headache phase, regional cerebral blood flow gradually changed from abnormally low to abnormally high without apparent change in headache. In some patients headache disappeared while regional cerebral blood flow remained increased. Although regional cerebral blood flow reduction and aura symptoms in the great majority of patients were unilateral, one-third had bilateral headache. Unilateral headache usually localized to the side on which regional cerebral blood flow was reduced and from which the aura symptoms originated (i.e., aura symptoms were perceived to occur contralaterally but presumably originated in the hypoperfused hemisphere). Our results suggest a simple model for migraine attacks: A pathological disturbance in one cerebral hemisphere causes the aura symptoms and after a time delay, it also causes the headache by stimulating local vascular nociceptors. Bilateral headache caused by a unilateral cerebral disturbance may be explained by recent neuroanatomical and neurophysiological findings.
Originalsprog Engelsk
Tidsskrift Annals of Neurology
Udgivelsesdato dec 1990
Vol/bind 28
Tidsskriftsnummer 6
Sider 791-8
Antal sider 8
ISSN 0364-5134
DOI
Status Udgivet

Transperineal seed-implantation guided by biplanar transrectal ultrasound

Holm, H. H., Torp-Pedersen, S. & Myschetzky, P. 1990 I : Urology. 36, 3, s. 249-52 4 s.

Publikation: Forskning - peer reviewTidsskriftartikel

A new method for precise transperineal placement of therapeutic sources in prostatic cancer is described. The method is a modification of the technique described in 1983 by Holm and coworkers. Insertion of needles is monitored by transverse as well as longitudinal transrectal ultrasound.
Originalsprog Engelsk
Tidsskrift Urology
Udgivelsesdato 1990
Vol/bind 36
Tidsskriftsnummer 3
Sider 249-52
Antal sider 4
ISSN 0090-4295
Status Udgivet

Published in 1989

Patients with polymyositis show changes in muscle protein charges

Bartels, E. M., Jacobsen, S., Rasmussen, L. & Danneskiold-Samsøe, B. dec. 1989 I : Journal of Rheumatology. 16, 12, s. 1542-4 3 s.

Publikation: Forskning - peer reviewTidsskriftartikel

Polymyositis (PM) appears with indolent proximal muscle weakness and is an inflammatory disease with breakdown of muscle cells. In our study the protein charge concentrations of the contractile proteins in the A and I bands were determined, applying a microelectrode technique. Patients with PM show a lower protein charge concentration than healthy control subjects which may be caused by the breakdown and removal of the proteins in the contractile filaments. A tool to judge the state of the disease as well as an aid in diagnosis may have been found in this method.
Originalsprog Engelsk
Tidsskrift Journal of Rheumatology
Vol/bind 16
Tidsskriftsnummer 12
Sider (fra-til) 1542-4
Antal sider 3
ISSN 0315-162X
Status Udgivet - dec. 1989

Published in 1987

Epilepsy after stroke

Olsen, T. S., Høgenhaven, H. & Thage, O. 1987 I : Neurology. 37, 7, s. 1209-11 3 s.

Publikation: Forskning - peer reviewTidsskriftartikel

Development of epilepsy was studied prospectively in a group of 77 consecutive stroke patients. Included were stroke patients less than 75 years old admitted within the first 3 days after the stroke. Excluded were patients with subarachnoid hemorrhage, vertebrobasilar stroke, and patients with other severe diseases. Cerebral angiography, CT, and EEG were performed in all patients. The patients were followed clinically for 2 to 4 years. Seven patients (9%) developed epilepsy. Of 23 patients with lesions involving the cortex, 6 (26%) developed epilepsy. Of 54 patients in whom the cortex was not involved, only 1 (2%) developed epilepsy. Patients with persisting paresis and cortical involvement seem to be at particularly high risk of developing epilepsy, as 50% of such patients (6 of 12) developed the disease.
Originalsprog Engelsk
Tidsskrift Neurology
Vol/bind 37
Tidsskriftsnummer 7
Sider (fra-til) 1209-11
Antal sider 3
ISSN 0028-3878
Status Udgivet - 1987

Conventional glucocorticoids exert a negative influence on calcium balance, and long-term treatment with these agents leads to osteopenia. Deflazacort is an oxazoline derivative of prednisolone with documented calcium-sparing properties when compared to prednisone on a weight basis. The purpose of the present study was to determine the relative antiinflammatory potency of deflazacort and prednisone. In a randomized, cross-over, double-blind trial, 11 patients, all suffering from polymyalgia rheumatica, and all on a stable maintenance dose of prednisone, were treated with equimolar doses of prednisone and deflazacort (i.e., weight ratio 1:1.2) for two consecutive 2-week periods. Following deflazacort treatment, significant rises compared with initial values were seen in erythrocyte sedimentation rate (ESR), plasma fibrinogen, serum alkaline phosphatase, and general pain and tenderness. No changes were seen following prednisone treatment. Subsequently, in a similar regimen, prednisone was compared with deflazacort at a weight ratio of 1:1.2 in 10 patients, 1:1.5 in another 10 patients, and 1:1.8 in still another 10 patients for purposes of dose titration. Again, significant rises were seen in ESR, plasma fibrinogen, and serum alkaline phosphatase following the lowest dose of deflazacort, whereas no changes were seen following the higher doses of deflazacort or prednisone. In conclusion, the relative antiinflammatory potency of deflazacort and prednisone lies between 0.83 and 0.66 on a weight basis (1.02 and 0.82 on a molar basis) as evaluated by clinical and biochemical parameters reflecting disease activity in polymyalgia. This disease appears to represent a sensitive, reliable and reproducible clinical model for assessment of the relative antiinflammatory potency of glucocorticoids.

Originalsprog Engelsk
Tidsskrift Calcified Tissue International
Vol/bind 41
Tidsskriftsnummer 6
Sider (fra-til) 316-320
Antal sider 5
ISSN 0171-967X
Status Udgivet - dec. 1987

Focal ischaemia caused by instability of cerebrovascular tone during attacks of hemiplegic migraine. A regional cerebral blood flow study

Friberg, L., Olsen, T. S., Roland, P. E. & Lassen, N. A. aug 1987 I : Brain. 110 ( Pt 4), s. 917-34 18 s.

Publikation: Forskning - peer reviewTidsskriftartikel

During the course of hemiplegic migraine in 3 patients, changes in regional cerebral blood flow (rCBF) were recorded by the intracarotid 133Xe method and a 254 multidetector camera covering one hemisphere. The rCBF measurements were performed in conjunction with cerebral angiography. During repeated rCBF measurements all 3 patients developed focal hypoperfusion originating in the frontal lobe, subsequently spreading posteriorly to involve the precentral and postcentral regions. In 2 cases focal hyperperfusion appeared to precede the hypoperfusion. In association with the rCBF changes the patients developed transient motor and/or sensory deficits and subsequently severe headache. No signs of arterial occlusion were found. In the over and underperfused regions blood flow fluctuated rapidly because of instability of cerebrovascular tone, defined as transient constriction of the smallest cerebral vessels (arterioles) alternating with a normal calibre for these vessels and/or short periods of vasodilatation. It is considered to be a primary pathological condition of the vessels. When vasoconstriction was present the blood flow decreased to values consistent with ischaemia, which was probably the cause of the neurological deficits. On the basis of these observations and previous work from our laboratory we conclude that instability of cerebrovascular tone may cause focal ischaemia during the course of attacks of classical and hemiplegic migraine.
Originalsprog Engelsk
Tidsskrift Brain
Udgivelsesdato aug 1987
Vol/bind 110 ( Pt 4)
Sider 917-34
Antal sider 18
ISSN 0006-8950
Status Udgivet
A common complaint among patients with fibrositis syndrome is exhaustion and fatique. It was therefore felt desirable to evaluate the muscle strength of these patients compared with normal subjects. Maximum isometric and isokinetic strength of knee extension was measured in 15 patients and 15 healthy matched subjects, using an isokinetic dynamometer (Cybex II). Maximum isometric strength at various knee extension angles (90 degrees, 60 degrees and 30 degrees degrees) was significantly (p less than 0.001) lower in the fibrositis group than in controls, a reduction of approximately 58-66%. Maximum isokinetic strength at various knee extension velocities (30-240 degrees per second) was also significantly (p less than 0.01) lower in the fibrositis group than in controls, the reduction being approximately 41-51%. In conclusion, isometric and isokinetic muscle strength is found to be lower in patients with fibrositis syndrome than in healthy subjects.
Originalsprog Engelsk
Tidsskrift Scandinavian Journal of Rheumatology
Vol/bind 16
Tidsskriftsnummer 1
Sider (fra-til) 61-5
Antal sider 5
ISSN 0300-9742
Status Udgivet - 1987

Published in 1985

Cerebral blood flow by xenon-133 washout: Tomographic/nontomographic metods compared

Kastrup, J., Olsen, T. S., Christensen, J., Sugiyama, H., Parving, H-H. & Lassen, N. A. 1985 I : Journal of Cerebral Blood Flow and Metabolism. s. 653-4 2 s.

Publikation: Forskning - peer reviewTidsskriftartikel

Originalsprog Engelsk
Tidsskrift Journal of Cerebral Blood Flow and Metabolism
Sider (fra-til) 653-4
Antal sider 2
ISSN 0271-678X
Status Udgivet - 1985

Focal increase of blood flow in the cerebral cortex of man during vestibular stimulation

Friberg, L., Olsen, T. S., Roland, P. E., Paulson, O. B. & Lassen, N. A. sep 1985 I : Brain. 108 ( Pt 3), s. 609-23 15 s.

Publikation: Forskning - peer reviewTidsskriftartikel

This study is an attempt to reveal projection areas for vestibular afferents to the human brain. Changes in regional cerebral blood flow (rCBF) were measured over 254 cortical regions during caloric vestibular stimulation with warm water (44 degrees C). rCBF was measured when the external auditory meatus was irrigated with water at body temperature as a control to vestibular stimulation. During vestibular stimulation there was only a single cortical area, located in the superior temporal region, which showed a consistent focal activation in the hemisphere contralateral to the stimulated side. On the rCBF display this area was located in the superior temporal region posterior to the auditory area, probably in the superior temporal gyrus. It is suggested that this area represents the primary projection area of the vestibular nerve and that it is the activation of this area during caloric stimulation that gives rise to the associated conscious vestibular sensation of vertigo.
Originalsprog Engelsk
Tidsskrift Brain
Udgivelsesdato sep 1985
Vol/bind 108 ( Pt 3)
Sider 609-23
Antal sider 15
ISSN 0006-8950
Status Udgivet

Published in 1984

The present study investigates the pathogenesis of focal cerebral hyperemia, its effect on brain tissue and discusses its pathophysiological and therapeutic importance in the light of interpreting severe hyperemia as a sign of arterial reopening probably due to embolic migration. Cerebral angiography, serial CT-scans and serial TC99 -scans were performed in a consecutive group of 73 patients with completed stroke all admitted to hospital within 3 days after stroke onset. When possible the regional cerebral blood flow (rCBF) was studied with the intracarotid Xe 133 injection method. Twenty-nine patients had evidence of middle cerebral artery (MCA) occlusion; rCBF was investigated in 24. Fourteen patients had either occlusion or severe internal carotid artery (ICA) stenosis; rCBF was not measured in these patients. Thirty patients had no angiographical evidence of MCA occlusion, ICA occlusion or severe ICA stenosis; rCBF was investigated in 24. Focal hyperemia was observed in 21 patients but exclusively in the group with evidence of MCA occlusion. Hence, these 21 patients are typical and representative for the group of patients with evidence of MCA occlusion. Hyperemia was found in infarcted as well as in non-infarcted tissue. Apparently, it is the severity of the initial ischemic episode and not the hyperemia that determines whether or not tissue necrosis develops. Interpreting severe hyperemia as a sign of arterial reopening and embolic migration (evidenced by partial reopening affecting only some MCA branches) reopening had occurred in about 1/3 of the patients with MCA occlusion before they were examined 1 to 4 days after stroke onset. Autopsy studies performed in 8 of the patients with MCA occlusion indicate that arterial reopening also takes place in many patients later on (7 of 8). According to this interpretation, hypothetical as it is, the changing position of the embolus is associated with partial or complete reperfusion leading to hyperemia in the initially ischemic brain tissue. The hemodynamic basis for appropriate therapy therefore may change from one day to the next in the acute state of stroke due to MCA occlusion.
Originalsprog Engelsk
Tidsskrift Stroke
Udgivelsesdato 1984
Vol/bind 15
Tidsskriftsnummer 3
Sider 458-68
Antal sider 11
ISSN 0039-2499
Status Udgivet

Thyroid stimulating immunoglobulins in Graves' disease with goitre growth, low thyroxine and increasing triiodothyronine during PTU treatment

Hegedüs, L., Hansen, J. M., Bech, K., Kampmann, J. P., Jensen, K., Andersen, E., Hansen, P., Karstrup, S. & Bliddal, H. dec. 1984 I : Acta Endocrinologica (Copenh). 107, 4, s. 482-8 7 s.

Publikation: Forskning - peer reviewTidsskriftartikel

In 50 consecutive patients with Graves' disease treated with PTU, 7 (group 1) developed increasing goitre in spite of unmeasurable TSH. Thyroid variables were compared with those from 10 controls with an ordinary response to PTU (group 2). Serum T4 decreased in group 1 from 246 +/- 47 nmol/l (mean +/- SD) to 40 +/- 9 nmol/l after 6 weeks of PTU treatment and continued to be below the normal range during the next 4 months. In group 2 serum T4 decreased from 190 +/- 35 to 88 +/- 47 nmol/l and stayed in the normal range. Serum T3 was normalized in both groups after 6 weeks but increased to values above the normal range in group 1 after that time. In spite of unmeasurable TSH during the 6 months of treatment in group 1, thyroid volume, determined ultrasonically, increased significantly from 60 +/- 29 to 93 +/- 68 ml (P less than 0.05), but was unaltered in group 2 about 25 ml. Thyroid stimulating antibodies (TSAb) measured by adenylate cyclase activation (normal below 109%) decreased in group 2 from 117 +/- 23 to 90 +/- 17% (P less than 0.01) (6 months of therapy), but increased significantly in group 1, from 201 +/- 47% to a maximum value of 234 +/- 69% (P less than 0.05). TSH binding inhibitory immunoglobulins (TBII) (given as per cent inhibition, normal below 26%) decreased in group 2 from 43 +/- 29 to 29 +/- 27% (P less than 0.05) but were unaltered high in group 1, 66 +/- 25% before therapy and 57 +/- 26% after 6 months of therapy.(ABSTRACT TRUNCATED AT 250 WORDS)
Originalsprog Engelsk
Tidsskrift Acta Endocrinologica (Copenh)
Vol/bind 107
Tidsskriftsnummer 4
Sider (fra-til) 482-8
Antal sider 7
ISSN 0001-5598
Status Udgivet - dec. 1984

Published in 1983

Blood flow and vascular reactivity in collaterally perfused brain tissue. Evidence of an ischemic penumbra in patients with acute stroke

Olsen, T. S., Larsen, B., Herning, M., Skriver, E. B. & Lassen, N. A. 1983 I : Stroke. 14, 3, s. 332-41 10 s.

Publikation: Forskning - peer reviewTidsskriftartikel

In a group of 48 patients with completed stroke, 8 patients had viable collaterally perfused brain tissue which was accessible for rCBF recordings with a two dimensional technique. All 8 had deep subcortical infarcts on CT-scan, and angiographic occlusion of the arteries normally supplying the infarcted territory. The brain tissue overlying the deep infarcts appeared normal on CT-scan and was supplied by collateral circulation. rCBF was measured in all within 72 hours after the stroke. The intra-carotid Xe-133 injection method and a 254 multidetector camera were used to study rCBF. Relatively ischemic low flow areas were a constant finding in the collaterally perfused tissue. In 6 of the patients, the collaterally perfused part of the brain had low flow values comparable to those of an "ischemic penumbra" (viable, but functionally depressed brain tissue due to inadequate perfusion). Autoregulation was impaired in all of the collaterally perfused areas while the CO2-response always was preserved. Steal phenomena were not seen. In the surrounding brain tissue, autoregulation was normal in 5 patients and impaired in 3 while the CO2-response seemed to be normal. The results confirm the experimental finding of an ischemic penumbra associated with acute cerebral infarcts and suggest that early restoration of the blood flow in acute stroke patients might improve recovery and prognosis in selected patients.
Originalsprog Engelsk
Tidsskrift Stroke
Udgivelsesdato 1983
Vol/bind 14
Tidsskriftsnummer 3
Sider 332-41
Antal sider 10
ISSN 0039-2499
Status Udgivet
Brain scintigraphy with Tc99-pertechnetate (Tc99-scan) was performed 4 times in 95 consecutive stroke patients: on average 5 days, 18 days, 103 days and 194 days after the stroke. The type (infarct, hematoma), size and localisation of the lesion was evaluated by CT-scan performed 3 times in all: on average 3 days, 18 days and 207 days after the stroke. The detection rate of Tc99-scan was 31% on day 5, 47% on day 18, 18% on day 103 and 9% on day 194. The detection rate was however highly dependent upon: (i) the localisation of the lesion, i.e. superficially localised lesions were nearly always identified (90%) while infarcts localised deep in the hemisphere were identified in only 20% of the patients; (ii) the size of the lesion, i.e. large deep infarcts were seen with a much higher frequency than small deep infarcts. The detection rate of the CT-scan was practically not dependent upon the time of investigation: 63% on day 3, 70% on day 18, 69% on day 207. The detection rate of the Tc99-scan and CT-scan was nearly identical for large superficially localised lesions 2-3 weeks after the stroke. In this period, however, CT-scan identified 30 deep infarcts. Only 12 of these were identified by Tc99-scan.
Originalsprog Engelsk
Tidsskrift Acta Neurologica Scandinavica
Vol/bind 67
Tidsskriftsnummer 4
Sider (fra-til) 229-34
Antal sider 6
ISSN 0001-6314
Status Udgivet - apr. 1983

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