A novel method of hybrid intraoperative catheter-based closure of ventricular septal defects using the Amplatzer® PDA occluder.

Background: In five patients, an apical muscular septal defect was closed in a hybrid approach using the Amplatzer® duct occluder during open heart surgery, whereas concomitant defects were treated surgically. In addition to their different heart defects that needed surgery, all had a muscular ventricular septal defect in the apex of the heart, poorly accessible for traditional, surgical approach. We describe the method and outcome in these patients.

Balloon dilatation of pulmonary artery banding: Norwegian experience over more than 20 years.

Aims: The purpose of this paper was to present the results of a simple modification of the suture technique for pulmonary artery banding (PAB), which allows for stepwise debanding by use of balloon catheter.

Methods And Results: During the period 1985-2007, PAB operations were performed in 227 children at Rikshospitalet. Of these children, 14.

Improved bone ingrowth and fixation with a thin calcium phosphate coating intended for complete resorption.

Bonit is claimed to be a resorbable electrochemically deposited calcium phosphate coating consisting mainly of brushite, which is a hydroxyapatite precursor. This study involved a comparison of Ti6Al4V screw-shaped implants with and without a 15 +/- 5 microm Bonit coating in rabbit tibia and femur, after 6 and 12 weeks of insertion. The biomechanical removal torque test showed significantly increased values for the coated implants after 12 weeks (p < 0.

Effects of a computerized system to support shared decision making in symptom management of cancer patients: preliminary results.

Objective: (1) To evaluate preliminary effects of a computerized support system on congruence between patients' reported symptoms and preferences and those addressed in the patient consultation and (2) to investigate the system's ease of use, time requirements, and patient satisfaction.

Design: Fifty-two patients were randomly assigned to intervention or control conditions.

Measurements: Cancer patients scheduled for an outpatient visit used the system on a tablet computer to report their symptoms and preferences prior to their consultation.

Induction of cytokine production in human T cells and monocytes by highly purified lipoteichoic acid: involvement of Toll-like receptors and CD14.

Background: The pro-inflammatory potential of lipoteichoic acid (LTA) from Staphylococcus aureus is controversial. The present study was undertaken to examine the ability of highly purified and characterized S. aureus LTA to stimulate the production of pro-inflammatory cytokines in human leukocytes at both mRNA and protein level, and to study the involvement of Toll-like receptors (TLRs) and CD14 in this response.

The significance of heparin-coated veno-venous bypass circuits in liver transplantation.

We studied the effects of veno-venous bypass (VVBP) circuit surface heparinization on the activation of the plasma defence systems (coagulation, fibrinolysis, kallikrein-kinin and complement) and leukocyte activation in a prospective randomized study in 20 patients during and 1 day after liver transplantation (OLT). To our knowledge, this is the first study of this kind where the possible benefits of surface heparinization of the VVBP circuit in OLT have been investigated. Twenty patients were randomized to either heparin-coated (HC) VVBP equipment or to otherwise identical noncoated (NC) circuits.

From operating theatre to operating studio--visualizing surgery in the age of telemedicine.

We have conducted a telemedicine project between two of Norway's largest hospitals (Rikshospitalet and Ullevål Hospital) with a focus on image-guided surgical and radiological procedures. Video was broadcast using a 34 Mbit/s ATM network. This resulted in changes in the local work practice to accommodate and facilitate the communication.

Veno-venous bypass in liver transplantation: heparin-coated perfusion circuits reduce the activation of humoral defense systems in an in vitro model.

We studied the effects of bypass circuit surface heparinization on kallikrein-kinin, coagulation, fibrinolytic and complement activation in a closed model system for simulating veno-venous bypass (WBP) in orthotopic liver transplantation (OLT). The circuits were identical to those in routine use during clinical OLT in our institution. Fresh whole human blood diluted 1:2 with Ringer's acetate was circulated at a non-pulsatile flow (2 l/min) and at a constant temperature (37.

Involvement of CD14 and toll-like receptors in activation of human monocytes by Aspergillus fumigatus hyphae.

Invasive fungal infections represent an increasing problem associated with high mortality. The present study was undertaken to identify leukocyte subsets that are activated by hyphal fragments in a whole-human-blood model, as well as to examine the involvement of CD14 and Toll-like receptors (TLRs) in activation of monocytes by hyphae. Incubation of whole human blood with hyphal fragments from Aspergillus fumigatus and Scedosporium prolificans for 6 h caused induction of mRNAs for tumor necrosis factor alpha (TNF-alpha), interleukin-1beta (IL-1beta), and IL-6 in T cells, B cells, and monocytes, but not in granulocytes, as analyzed by reverse transcription-PCR with mRNA isolated from very pure populations of these leukocyte subsets.

Chelating agents.

The antibacterial activity of metal ions, metal chelates, and molecules with chelating ability for polyvalent cations have been evaluated. The chelator N, N'-ethylenebis[2-(2-hydroxyphenyl)-glycine] (EHPG) exerted moderate-to-good activity against isolates of pathogenic bacteria and fungi. Other chelating agents such as ethylenediamine-tetraacetic acid (EDTA) and diethylene-triamine-pentaacetic acid (DTPA) revealed weak-to-moderate activity.

Peptidoglycan and lipoteichoic acid from Staphylococcus aureus induce tumor necrosis factor alpha, interleukin 6 (IL-6), and IL-10 production in both T cells and monocytes in a human whole blood model.

We have examined the ability of peptidoglycan (PepG) and lipoteichoic acid (LTA) isolated from Staphylococcus aureus to induce the release of tumor necrosis factor alpha (TNF-alpha), interleukin-6 (IL-6), and IL-10 in whole human blood and identified the cellular origins of these cytokines. Both PepG and LTA induced transient increases in TNF-alpha and IL-10 in plasma, with peak values at 6 and 12 h, respectively. IL-6 values increased throughout the experimental period (24 h).

Cytokine modulation in experimental endotoxemia: characterization of an ex vivo whole blood model.

A new model was developed to study cytokine regulation and modulation in whole blood ex vivo. The model is characterized by stable leukocyte counts and high leukocyte viability throughout the experimental period. Oxygen consumption per time decreased slowly, whereas carbon dioxide partial pressure increased accordingly throughout the experiment.

Normal CD4 T-cell receptor repertoire in tonsillar tissue despite perturbed repertoire in peripheral blood in HIV-1 infected individuals.

Objective: To compare the T-cell receptor (TCR) repertoire of T-cell subsets in peripheral blood and lymphoid tissue from HIV-1 infected individuals.

Design: Biopsies of tonsillar tissue and samples of peripheral blood were obtained from 10, mostly treatment-naive, HIV-1-infected individuals. CD4 and CD8 T-cell subsets were quantified, the TCR repertoire was analysed within 'naive' and 'memory' subsets, and results compared between identical subsets in tonsillar tissue and blood.

The T cell receptor repertoire of CD8+CD28- T lymphocytes is dominated by expanded clones that persist over time.

The costimulatory molecule CD28 is expressed on almost all CD4+ T cells, but on only a portion of CD8+ T cells in healthy human adults. alpha beta T cells may thus be divided into three phenotypically and functionally different subsets: CD4+, CD8+CD28+ and CD8+CD28-. Using peripheral blood lymphocytes from six healthy adults, we have studied the T cell receptor (TCR) repertoire within these subsets by analysis of the distribution of lengths of the complementarity determining region 3 (CDR3) of the beta variable (BV) transcripts and flow cytometric analysis of TCR V beta usage.

Molecular analysis of the complementarity determining region 3 of the human T cell receptor beta chain. Establishment of a reference panel of CDR3 lengths from phytohaemagglutinin activated lymphocytes.

The T cell receptor (TCR) repertoire of a lymphocyte population may be characterized by the distribution of lengths of the hypervariable fragment known as the complementarity determining region 3 (CDR3). Immunological activity leading to clonal predominance will result in an over-representation of given CDR3 lengths and a distortion of the CDR3 length distribution. CDR3 length distribution may be studied by the in vitro amplification of TCRB cDNA followed by gel electrophoresis of the resulting product.

In vivo expansion coincident with excessive in vitro cell death within the memory subset of CD8+ T cells in HIV type 1 infection.

In HIV-1-infected individuals the CD8+ T cell subset is considerably expanded. This has been shown to be caused predominantly by an increase in the number of CD8+CD28- T cells. To characterize further the subsets of CD8+ T cells, we have performed analyses of cell surface phenotype, T cell receptor Vbeta usage, and ability to survive in unstimulated cultures.

Fenfluramine and idiopathic pain: a serotonergic study in non-psychiatric patients with functional gastrointestinal disorder.

Background: We investigated prolactin and cortisol response to fenfluramine in non-psychiatric patients with chronic functional gastrointestinal disorder (FGD).

Methods: Sixty milligrams fenfluramine was given orally to 55 subjects without any DSM-III axis-1 psychopathology and 29 healthy control subjects matched for sex and age. Serum cortisol and prolactin levels were analysed at base line and after 120, 180, and 240 min.

Demonstration of identical expanded clones within both CD8+CD28+ and CD8+CD28- T cell subsets in HIV type 1-infected individuals.

In HIV-1-infected individuals, the CD8+CD28- T cell subset is considerably expanded and is frequently the largest subset of T cells found in peripheral blood. It has been assumed, but not proven, that CD8+CD28- T cells derive from CD8+CD28+ T cells in vivo. To further study the ontogeny of CD8+CD28- T cells, we have performed analyses of the complementarity determining region 3 (CDR3) of the TCRB of CD8+CD28+ and CD8+CD28- T cells from the peripheral blood of HIV-1-infected individuals.

Direct detection of Mycobacterium tuberculosis complex in clinical samples from patients in Norway by ligase chain reaction.

Our aim was to investigate the use of DNA amplification with the ligase chain reaction (LCR) for detection of the Mycobacterium tuberculosis complex directly in human clinical specimens. The LCR assay employed was the Abbott LCx MTB Assay, which uses the gene encoding protein antigen b as the target template. Four hundred eighty-two samples from 457 patients in one clinical microbiology laboratory in Norway were processed by routine culture analysis (BACTEC culture), direct microscopy (Ziehl-Neelsen staining) and LCR.

The pilus colonization factor of pathogenic neisserial species: organelle biogenesis and structure/function relationships--a review.

Type-IV pilus expression plays a critical role in the interactions between Neisseria gonorrhoeae, Neisseria meningitidis and their human host. We have focused on experiments designed to elucidate the mechanisms of organelle biogenesis as one means of understanding the complexities of pilus biology in these species. Employing a variety of approaches, genes and gene products essential to pilus biogenesis have been identified and characterized.

Strict adherence to a common rank order of T-cell receptor V beta usage in human leucocyte antigen disparate individuals.

In order to investigate the T-cell receptor (TCR) V beta usage in different T-cell subsets, the authors performed flow cytometric analyses using a large panel of TCR V beta-specific monoclonal antibodies on CD4+, CD8+ CD28+ and CD8+ CD28- T cells from 15 random blood donors, six umbilical cords and seven human leucocyte antigen (HLA) identical non-twin sibling pairs. The authors found that the proportion of T cells expressing each V beta gene product was similar within CD4+ and CD8+ CD28+ T cells from all samples studied. For these T-cell subsets a rank order of V beta usage could be identified which was adhered to by all donors.

Direct detection of Mycobacterium tuberculosis in respiratory samples from patients in Scandinavia by polymerase chain reaction.

OBJECTIVE: To investigate the use of DNA amplification by the polymerase chain reaction (PCR) for the detection of Mycobacterium tuberculosis directly in human respiratory specimens. METHODS: The PCR assay employed was the Amplicor M. tuberculosis Test (Roche Diagnostics, Switzerland), which uses the 16S rDNA as the target template.

Aesthetic treatment of progressive hemifacial atrophy (Romberg's disease): use of a pedicled platysma muscle flap.

Several methods have been described for anesthetic correction of Romberg's disease. We have used the platysma muscle flap as the only procedure in four cases of severe to moderate disease. The platysma flap was transected at the clavicular level, turned at the mandibular margin, and spread subcutaneously on the affected side from the nasolabial fold up to the orbital margin and laterally to the anterior part of the ear.

Contraction of knee flexors and extensors in skiing related to the backward fall mechanism of injury to the anterior cruciate ligament.

The purpose of this study was to examine the motion pattern and muscle activity during jumping and landing in downhill skiing to estimate the muscular involvement during the jump-landing-backward fall-anterior cruciate ligament (ACL) injury. A digitized 2-D video motion analysis and a synchronous 8-channel electromyography registration was performed over a jump on a downhill slope during 3 runs by 2 skiers and during 6 control jumps in the laboratory. The knee flexors (lateral gastrocnemius and biceps femoris) were recruited before touchdown and mean 60 ms earlier than the extensors (vastus lateralis and rectus femoris).