Search PubMed⌕ Search

Biomedical subjects

A Ek

Publications and source records attributed to A Ek.

At least 19 recordsLinked to original sources
PubMed2004

The effect of fluticasone on the airway inflammatory response to organic dust.

Exposure to organic dust in a swine house causes acute airway inflammation and increased bronchial responsiveness to methacholine in healthy subjects. The aim of this study was to investigate whether an inhaled glucocorticoid, fluticasone propionate, alters the acute airway responses induced by exposure in a swine barn. In 15 healthy subjects, analysis of nasal lavage fluids, serum samples and bronchial methacholine responsiveness were performed before and after exposure to organic dust in a swine house for 3 h. Seven subjects received fluticasone propionate (500 microg b.i.d. by inhalation and 100 microg intranasally once daily) and eight subjects received placebo during the 2 weeks prior to exposure. Post-exposure plasma interleukin (IL)-6 levels and body temperature were significantly lower in the fluticasone group than in the placebo group. Intranasally administered fluticasone propionate significantly attenuated the plasma protein (assessed as albumin concentrations) leakage and IL-8 and tumour necrosis factor-alpha response induced by exposure. Fluticasone propionate inhalation exerted no influence on the increased bronchial responsiveness to methacholine induced by exposure. In conclusion, glucocorticoid treatment attenuated the inflammatory response to inhaled organic dust without influencing the increased bronchial responsiveness to methacholine.

Administration, Inhalation↗
PubMed2001

Is a dissection balloon beneficial in totally extraperitoneal endoscopic hernioplasty (TEP)? A randomized prospective multicenter study.

BACKGROUND: Laparoscopic hernioplasty has been criticized because of its technical complexity and increased costs. Disposable dissection balloons can be used to facilitate the creation of the initial working space in totally extraperitoneal endoscopic hernioplasty (TEP), but their use adds to the cost of the operation. METHODS: A total of 322 men with unilateral, primary, or recurrent inguinal hernias were randomized to undergo TEP with or without a dissection balloon. RESULTS: In the group with the balloon, three of 161 patients (2.5%) required conversion to transabdominal preperitoneal hernioplasty (TAPP), or open herniorraphy, whereas 17 of 161 patients (10.6%) were converted to TAPP or open herniorraphy in the group without the balloon (p = 0.002). The mean operation time was 55 min in the group with the balloon and 63 min in the group without the balloon (p = 0.004). There was no difference between them in postoperative morbidity, and there were no major complications in either group. The recurrence rate was 3.1% in the group with the balloon and 3.7 % in the group without the balloon (p = 0.8). CONCLUSION: The use of a dissection balloon in TEP reduces the conversion rate and may be especially beneficial early in the learning curve.

Adult↗
PubMed2001

Is a dissection balloon beneficial in bilateral, totally extraperitoneal, endoscopic hernioplasty? A randomized, prospective, multicenter study.

SUMMARY: Laparoscopic hernioplasty has been criticized because of its technical complexity and increased costs. Disposable dissection balloons can be used to gain the initial working space in totally extraperitoneal endoscopic (TEP) hernioplasty, but this increases its cost. Forty-four men with bilateral, primary or recurrent inguinal hernias were randomized to undergo TEP with or without dissection balloon. There were two conversions to transabdominal preperitoneal hernioplasty, or open herniorrhaphy, in the group with balloon and four in the group without balloon. There was no difference in the postoperative morbidity or operation time between the two groups, and there were no major complications in either group. The recurrence rate was 4.3% in the group with the balloon and 7.1% in the group without the balloon. There were no statistically significant differences between the groups. Although our study population is too small to detect small differences between the groups, it seems that the use of a dissection balloon is not beneficial in a bilateral TEP.

Adult↗
PubMed2000

Ability for self-care among home dwelling elderly people in a health district in Sweden.

The aim of this study was to describe the ability for self-care among home dwelling elderly in the community in a health district in western Sweden. Two self-report instruments plus a number of self-care related questions were distributed by mail to an age stratified random sample and finally completed by a total of 125 subjects. Bivariate and multivariate statistical methods were used in the analyses. The results showed that self-care ability and self-care agency decreased for respondents 75+ years of age. Self-care ability was predicted by three productive means for self-care and four risk factors.

Activities of Daily Living↗
PubMed2000

Influence of fluticasone and salmeterol on airway effects of inhaled organic dust;an in vivo and ex vivo study.

Inhalation of dust from swine confinement buildings induces airway inflammation with an increase in both inflammatory cell numbers and secretion of proinflammatory cytokines in the lungs. It is not known whether anti-asthma drugs, which influence airway inflammation in asthma, also influence the airway reaction to inhaled organic dust. In the present study we examined the effects of a ss2-agonist (salmeterol) and an inhaled steroid (fluticasone) on the swine dust-induced cell and cytokine content of the lower airways, and cytokine release in cultured alveolar macrophages. Healthy volunteers were pretreated with inhaled salmeterol (n = 8), fluticasone propionate (n = 8) or placebo (n = 8) for about 2 weeks and exposed to dust in a pig house. Bronchoalveolar lavage was performed both before medication and after dust exposure. Cell differential counts and cytokine analyses in bronchoalveolar lavage fluid (BALF) were examined. Alveolar macrophages were cultured and cytokine release was studied, both in unstimulated cells and after lipopolysaccharide (LPS) stimulation. Unstimulated alveolar macrophages from swine dust-exposed individuals released less IL-6, IL-8 and tumour necrosis factor-alpha (TNF-alpha) after, than before, exposure (P < 0.01). Medication did not influence basal cytokine production. Fluticasone inhibited LPS-induced IL-6 and IL-8 release (P < 0.05). There was no significant difference between the groups. There was a large and significant increase (P < 0.05) in alveolar macrophage, granulocyte, lymphocyte numbers, and IL-6 and TNF-alpha content in BALF in all three groups following dust exposure, with no significant difference between the groups. These findings suggest that drugs which are known to influence and control airway inflammation in asthma do not have major effects on airway inflammation induced by the inhalation of organic dust.

Adrenergic beta-Agonists↗
PubMed2000

Design and evaluation of a software prototype for participatory planning of environmental adaptations.

A software prototype to support the planning process for adapting home and work environments for people with physical disabilities was designed and later evaluated. The prototype exploits low-cost three-dimensional (3-D) graphics products in the home computer market. The essential features of the prototype are: interactive rendering with optional hardware acceleration, interactive walk-throughs, direct manipulation tools for moving objects and measuring distances, and import of 3-D-objects from a library. A usability study was conducted, consisting of two test sessions (three weeks apart) and a final interview. The prototype was then tested and evaluated by representatives of future users: five occupational therapist students, and four persons with physical disability, with no previous experience of the prototype. Emphasis in the usability study was placed on the prototype's efficiency and learnability. We found that it is possible to realise a planning tool for environmental adaptations, both regarding usability and technical efficiency. The usability evaluation confirms our findings from previous case studies, regarding the relevance and positive attitude towards this kind of planning tool. Although the prototype was found to be satisfactorily efficient for the basic tasks, the paper presents several suggestions for improvement of future prototype versions.

Activities of Daily Living↗
PubMed1999

Fluticasone and budesonide inhibit cytokine release in human lung epithelial cells and alveolar macrophages.

Glucocorticoids are potent anti-inflammatory agents capable of influencing cytokine release in a number of cell types. The aim of the present study was to investigate whether glucocorticoids, frequently used in the treatment of asthma, interfere with cytokine secretion by lung epithelial cells and alveolar macrophages in vitro. Inhalation of swine dust induces airway inflammation with influx of inflammatory cells and release of proinflammatory cytokines in the lungs. Therefore, human lung epithelial cells (A549) and human alveolar macrophages were stimulated with swine dust or lipopolysaccharide (LPS), and the inhibitory effect of budesonide and fluticasone propionate on cytokine release was studied in a dose-response (10(-13)-10(-8) M) manner. The time course for the steroid effect was also investigated. Both steroids caused a dose-dependent, almost total, inhibition of swine dust-induced IL-6 and IL-8 release from epithelial cells and LPS-induced IL-6 and TNF-alpha from alveolar macrophages. The steroids only partially inhibited IL-8 release from alveolar macrophages. Budesonide was approximately 10 times less potent than fluticasone propionate. Preincubation with the steroids did not inhibit cytokine release more than simultaneous incubation with stimulus and steroid. In conclusion, budesonide and fluticasone propionate, in concentrations that probably occur in the airway lining fluid during inhalational therapy, inhibited cytokine release from human lung epithelial cells (IL-6, IL-8) and alveolar macrophages (TNF-alpha, IL-6, IL-8). In vitro, the onset of this effect was rapid.

Adult↗
PubMed1999

Swine dust induces cytokine secretion from human epithelial cells and alveolar macrophages.

Exposure to swine dust causes airway inflammation with increased levels of proinflammatory cytokines, and inflammatory cells in nasal and bronchoalveolar lavage fluid (BALF) in healthy subjects. Earlier studies have suggested that lipopolysaccharides (LPS) might be an important proinflammatory factor in swine dust. Since respiratory epithelial cells and alveolar macrophages are target cells for the inhaled dust, we therefore compared the release of proinflammatory cytokines from normal human bronchial epithelial cells (NHBE), an epithelial cell line (A549) and from human alveolar macrophages obtained from BALF from healthy subjects in vitro after incubation with dust collected in swine houses or LPS. Swine dust or LPS was added to the wells with A549 cells or macrophages and incubated for 8 h at concentrations of 12.5, 25, 50 and 100 microg/ml. NHBE cells were incubated with swine dust at a concentration of 25, 50 or 100 microg/ml or with LPS at a concentration of 50 or 100 microg/ml and incubated for 24 h. The supernatants were collected, centrifuged, and IL-6, IL-1beta and tumour necrosis factor-alpha (TNF-alpha) production was measured using an ELISA method and expressed per 106 cells. Swine dust and LPS caused a dose-dependent increase of IL-6 production in NHBE cells, swine dust being more potent than LPS. In A549 cells, only swine dust, but not LPS caused an increase of IL-6 production. Neither swine dust nor LPS induced IL-1beta or TNF-alpha release from A549 cells. Both swine dust and LPS caused a dose-dependent increase of IL-1beta, IL-6 and TNF-alpha in alveolar macrophages. Swine dust which contained 2.2 (0.2) ng endotoxin/100 microg swine dust (0.02 per thousand) was almost as potent as LPS in inducing cytokine release from alveolar macrophages in vitro. We conclude that both epithelial cells and alveolar macrophages have the capability to contribute to the release of proinflammatory cytokines following exposure to swine dust. Some agent(s) other than LPS in the dust contribute to the marked airway inflammatory reaction.

Animals↗
PubMed1995

The uptake of ascorbic acid into human umbilical vein endothelial cells and its effect on oxidant insult.

Intracellular reduced ascorbate (AA) levels in confluent cultures of human umbilical vein endothelial (HUVE) cells, grown under conventional conditions, were shown to be very low, ranging between undetectable, < 0.1 nmol/mg protein, and 0.3 nmol/mg protein. Reduced ascorbate was accumulated into the endothelial cells from M199 culture medium in time- and concentration-dependent manners, and was saturated at medium concentrations related to the normal plasma concentrations of the antioxidant (i.e. between 50 microM and 100 microM). Cells derived from different individuals demonstrated considerable inter-individual variation in these AA uptake parameters. The uptake of AA was sensitive to temperature and the presence of the structural analogue isoascorbate in the medium, indicating the involvement of an active transport mechanism. A role for the glucose transporter is, however, not indicated, as AA uptake was not sensitive to phloretin, an inhibitor of the cellular glucose transporter, nor greatly enhanced by depletion of glucose from the medium. Incubation of HUVE cells with dehydroascorbate (DHAA) caused a dose-dependent, but transient increase in intracellular AA. This indicates that HUVE cells are both competent in the uptake and intracellular reduction of oxidised ascorbate, and may resecrete AA into the medium. Indeed, reduced ascorbate in the medium was shown to be preferentially maintained in the presence of cells. The uptake of AA was not sensitive to the presence of DHAA in the medium, perhaps indicating different transporters for reduced and oxidised forms of ascorbate in these human cells. Pre-loading HUVE cells with AA was shown to protect control cells only weakly from the acute, sub-lethal toxicity of H2O2 generated by xanthine oxidase (1 U/mL or 10 U/mL). Protection was optimal at intracellular levels of 3-4 nmol AA/mg protein, with higher concentrations lacking a protective effect. Additionally, the presence of the iron chelator, desferoxamine, significantly protected GSH-depleted HUVE cells only in response to the peroxide, but did not potentiate the protective action of intracellular AA in either control or GSH-depleted cells. This indicates that ascorbate-driven redox-cycling of the Fe2+/Fe3+ does not hamper the intracellular protective function of ascorbate during hydrogen peroxide-derived oxidative stress. These results are discussed in terms of the central role of endothelial cells in the distribution of AA to the tissues of the body, the use of the HUVE cell system for model studies of the toxicity of oxidants in the human endothelium, and the balance between the antioxidant and pro-oxidant actions of AA.

Ascorbic Acid↗
PubMed1989

Vectorcardiographic bites. A method for detection and quantification applied on a normal material.

Vectorcardiographic bites as an expression of small fibrotic or necrotic areas in the myocardium have been discussed for many years. Distinct definitions of bites and normal limits for bites have, however, not been established. Therefore, an algorithm for computer detection and quantification of bites is presented. To find a bite, sectors of the QRS loop rotating opposite the way of the main part of the loop (eg, a clockwise-rotating sector in an otherwise counterclockwise-rotated loop) are detected. The bite is then delineated, using an iterative procedure. Finally the amplitude, duration, and area of the bite are calculated. The method for detection and quantification was applied on a well-defined normal material to obtain normal limits for bites. The commonly used criterion for an abnormal bite (amplitude greater than or equal to 0.1 mV and duration greater than or equal to 10 msec in the horizontal or sagittal plane) results in a specificity of only 87%. A specificity of 95% is yielded with the criterion of bite amplitude greater than 0.15 mV in the horizontal or sagittal plane.

Adult↗
PubMed1986

Contelle: pelvic floor stimulator for female stress-urge incontinence. A multicenter study.

The clinical efficacy of a new device for treatment of female incontinence was studied in a multicenter trial. The device consists of an inflatable electrode carrier and an external stimulator unit. Forty women were treated: 10 had primary or recurrent genuine stress incontinence, 15 had urge incontinence due to idiopathic detrusor instability, not responding to drug treatment, and 15 had stress incontinence combined with detrusor instability. Twenty-five patients were improved by the treatment. Another 8 reported an excellent result of treatment and remained free of symptoms for more than six months after withdrawal of the treatment. The results were more favorable in patients with bladder hyperactivity than in genuine stress incontinence. The patients' general ratings of treatment efficacy correlated well with their recordings of urinary frequency and consumption of incontinence pads. The functional bladder capacity increased in improved patients, but normalization of urodynamic parameters was no prerequisite for clinical improvement. We found intravaginal electrical stimulation to be a valuable alternative to medical and surgical intervention in patients with detrusor instability.

Adult↗
PubMed1986

Huge bladder carcinoma successfully treated with hydrostatic pressure technique. A case report.

A 64-year-old man presented with acute urinary retention and anasarca due to noninvasive multiple papillary transitional cell carcinoma filling the whole bladder cavity and obstructing both ureters. He was treated with hydrostatic pressure distension. A dramatic response occurred, with complete disappearance of the tumour within one month of the treatment.

Carcinoma, Transitional Cell↗
PubMed1985

Ejaculation and sexual function after endoscopic bladder neck incision.

Endoscopic incision of the bladder neck, performed to relieve outflow obstruction, was evaluated as regards effects on ejaculation and orgasm in 61 men (mean age 48 years) by analyses of seminal fluid and a questionnaire. Relief of obstruction was confirmed by post-operative normalisation of urinary flow. In 47 cases there was unchanged antegrade ejaculation, while reduced semen volume was reported by 11 men and retrograde ejaculation by only 3. The quality of orgasm and sexual satisfaction were not permanently changed by the operation. Post-operative analysis of seminal fluid was performed in 27 patients, with normal results in 26. In 16 men who provided specimens both before and after bladder neck incision, no consistent change was found in the semen. An incision completely splitting the bladder neck but not extending distal to the verumontanum will relieve outlet obstruction. Maintenance of antegrade ejaculation can be expected in most patients undergoing this operation.

Adult↗
PubMed1984

Occlusion of renal arterial tumor supply with absolute ethanol. Experience with 20 cases.

Absolute ethanol was used for renal ablation in 20 patients with carcinoma of the kidney. The procedure was followed by nephrectomy in 6 patients without metastases, all of whom are alive without evidence of recurrence 4 to 20 months after treatment. Fourteen patients with metastatic or locally advanced disease were embolized to palliate pain or hematuria without subsequent nephrectomy. Of these only 2 are alive, 4 and 18 months following the procedure. The technique for ethanol embolization is described and the use of occluding balloon catheters is recommended. No complications were encountered and the 'postembolization syndrome' was less marked as compared with a previous material of equal size where other methods of renal artery occlusion were employed. Microscopic examination in 10 of the infarcted kidneys showed extensive tumor necroses, sometimes with no evidence of viable tumor cells at all. Natural killer cell activity was determined before and 48 hours after renal artery occlusion in 7 patients, showing somewhat increased activity in 4. It is concluded that absolute ethanol is a safe, effective and easily administered agent for the infarction of renal tumors.

Adenocarcinoma↗
PubMed1984

Intravesical adriamycin therapy in carcinoma in situ of the urinary bladder.

Intravesical Adriamycin treatment was given to 22 patients with carcinoma in situ of the urinary bladder. The treatment schedule consisted of monthly Adriamycin instillations in a dose related to bladder capacity. Endoscopic inspection with multiple bladder biopsies and cytoanalysis of urine was performed after every third instillation. In two patients there was lasting disappearance of the carcinoma in situ. Another 10 patients possibly had a beneficial effect of the treatment. The remaining 10 patients showed persistent malignancy and in 6 of these, progression of carcinoma in situ during Adriamycin treatment necessitated cystectomy or radiotherapy. The histologic and cytologic findings showed distinct variability in most patients, with atypia or even absence of malignant cells often followed by recurrence. Adriamycin was discontinued in four cases because of severe cystitis, and in one case because of an anaphylactoid reaction following instillation of the drug.

Aged↗