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Biomedical subjects

A Eklund

Publications and source records attributed to A Eklund.

At least 199 records · Page 11Linked to original sources

Accumulation of cholesteryl esters and triglycerides in cultured macrophages incubated with plasma very low density lipoproteins from rats fed on casein or soybean protein diets containing moderate levels of cholesterol.

Even when administered at a comparatively low level, dietary cholesterol produces significant changes in the properties of plasma lipoproteins in rats, particularly the d less than or equal to 1.006 g/ml fraction (VLDL). The occurrence of these changes is promoted by dietary casein. To test the hypothesis that these dietary-induced perturbations might include properties influencing lipoprotein-cell interactions of relevance to atherogenesis, cultured mouse peritoneal macrophages were incubated with VLDL isolated from male rats fed on diets containing either 0, 0.25 or 0.5% cholesterol with casein or soybean protein, respectively, as the sole source of protein. No increase in cholesteryl ester content, and a comparatively small rise in triglyceride content, was observed in macrophages incubated with VLDL from rats fed on cholesterol-free diets. In contrast, a significant and apparently saturable cellular accumulation of cholesteryl esters as well as triglycerides was produced by VLDL from cholesterol-fed rats. The curves showing cellular lipid accumulation versus VLDL-protein (or VLDL-cholesterol) content in the cell medium indicated different cellular affinity for VLDL from casein-fed rats in comparison with VLDL from soybean protein-fed rats. The apoprotein composition of VLDL differed between groups of rats fed on different types of dietary protein with higher proportions of apo C's in the casein-fed rats. In addition, cholesterol feeding resulted in increased proportions of apo A-I and apo A-IV in the plasma VLDL fraction.

Animals↗

Stimuli-induced superoxide radical generation in vitro by human alveolar macrophages from smokers: modulation by N-acetylcysteine treatment in vivo.

Bronchoalveolar lavage (BAL) was performed on nine healthy nonsmoking subjects and on 11 healthy smokers; in the last mentioned group lavage was performed before and after eight weeks treatment with N-acetylcysteine (NAC; 200 mg t.i.d.). The BAL cells were cultured for 2 h or overnight. Adherent cells were examined for their capacity to generate superoxide radicals (determined by superoxide dismutase (SOD)-inhibitable cytochrome C-reduction) at stimulation with phorbol 12-myristate 13-acetate (PMA), serum-treated zymosan (STZ), the calcium ionophore A23187, or the chemotactic tripeptide formyl-methionylleucylphenylalanine (FMLP). Cells from nonsmokers responded with a very low degree of O(2)-generation to any of the stimuli employed whether cultured for 2 h or overnight. Cells from smokers also responded with low O(2)-generation after 2 h of culture. However, cells from smokers cultured overnight responded with marked O(2)-generation to PMA and STZ but the responses to FMLP and A23187 were low. NAC-treatment of the smokers resulted in a reduced degree of both PMA- and STZ-induced O(2)-generation in five individuals. In two other subjects, PMA-induced (but not STZ-induced) O(2)-generation was reduced. Two individuals showed increased O(2)-generation to PMA- and to STZ-stimulation after NAC-treatment. Mean values of O(2)-generation induced by A23187 or by FMLP were significantly reduced for cells harvested after NAC-treatment. Mean values for PMA-induced O(2)-generation also tended to be reduced by the treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Acetylcysteine↗

Low-dose ketamine infusion for analgesia during postoperative ventilator treatment.

In a randomized, double-blind study with placebo, ketamine was used as an analgesic during ventilator treatment in the period of recovery after major abdominal surgery. Forty patients were orally intubated and ventilated by means of a volume-controlled ventilator. Twenty of them received an i.v. bolus of 30 mg of ketamine followed by an 8-h infusion of 1 mg per minute. End-tidal CO2-concentration was continuously monitored and ventilation was adjusted to metabolic demands prior to assessment of pain. If pain relief was not adequate, the infusion rate was doubled, and if this was still not sufficient, 5 mg injections of ketobemidone were given i.v. If the orotracheal tube was not tolerated, the internal branch of the superior laryngeal nerve was blocked. A total of 30 injections of ketobemidone were administered to 13 control patients, but only five were given to four ketamine patients. Ten control and three ketamine patients required an internal laryngeal nerve block. Dreams and hallucinations were recalled in three patients in the control group and five in the ketamine group. Only one control and two ketamine patients experienced these as unpleasant. In this investigation, ketamine infusion in a low dose appeared to offer satisfactory analgesia and to permit tolerance of the orotracheal tube.

Aged↗

Relationship between changed alveolar-capillary permeability and angiotensin converting enzyme activity in serum in sarcoidosis.

The effect of altered alveolar-capillary permeability on angiotensin converting enzyme (ACE) activity in serum (SACE) was studied in 45 patients with sarcoidosis and 21 healthy controls. In sarcoidosis increased albumin concentrations in the bronchoalveolar lavage fluid (L albumin) and increased ratios of L albumin to albumin in serum (S albumin) indicated an increased permeability of the alveolar-capillary membrane. ACE activity in the lavage fluid (LACE) was correlated with the number of alveolar macrophages in controls, indicating that it may come from these cells. LACE was high in active sarcoidosis while in inactive disease it was similar to that in controls. SACE in sarcoidosis was significantly increased. Ninety per cent of patients with increased L albumin had increased SACE. SACE activity was significantly correlated with concentrations of L albumin and with LACE activity. The relationships between signs of increased membrane permeability and SACE and between LACE and SACE suggest that excess SACE in sarcoidosis may, at least partly, originate in the alveolar space.

Adult↗

Haptoglobin groups and lung cancer.

Haptoglobin groups were investigated in 309 patients with primary lung cancer divided by sex, smoking habits and tumor type. Patients with squamous epithelial cancer and oat-cell cancer showed no significant difference from normal controls. Among patients with pulmonary adenocarcinoma the frequency of the Hp 2-2 type was significantly (p less than 0.05) lower compared to the controls, with a corresponding increase of the Hp 1-1 and Hp 2-1 types. This difference was more pronounced (p less than 0.025) among females with pulmonary adenocarcinoma.

Adenocarcinoma↗

Alveolar lymphocytes from patients with sarcoidosis respond poorly to activation by mitogenic lectins.

Attempts have been made to activate alveolar cells obtained by bronchoalveolar lavage from 17 patients with sarcoidosis in different stages with the lectins concanavalin A and leukoagglutinin. The cells obtained from 2 of the patients responded well by proliferation whereas the cells from the other 15 patients responded poorly. Coculture experiments indicate that the low proliferative response was not due to inhibitory effects exerted by alveolar lymphocytes or macrophages, but rather to a lack of responding T cells. The results are discussed in relation to other studies showing increased immune reactivity in alveolar lymphocytes from patients with sarcoidosis.

Adult↗

Sarcoidosis in an apparently healthy volunteer.

As previously reported in this journal, alveolitis may occur in asymptomatic individuals exposed to antigens known as causative agents in hypersensitivity pneumonitis. We found an alveolitis, probably of sarcoid origin, in an apparently healthy volunteer.

Adult↗

Hyaluronate in bronchoalveolar lavage fluid: a new marker in sarcoidosis reflecting pulmonary disease.

Hyaluronate (hyaluronic acid) was not detectable in bronchoalveolar lavage fluid from smoking or nonsmoking healthy volunteers but was present in fluid from 23 patients with sarcoidosis; the mean concentration was 16 micrograms/1 returned fluid (range less than or equal to 5-430) or, expressed in relation to the amount of albumin recovered, 0.22 micrograms/mg albumin (range less than or equal to 0.05-3.6). The serum hyaluronate concentrations in the patients with sarcoidosis were normal. There was a significant inverse correlation between vital lung capacity and hyaluronate concentrations in bronchoalveolar lavage fluid (p less than 0.001), and patients with abnormal lung volumes had hyaluronate concentrations that were on average six times higher than those in patients with normal vital capacity. Duration of disease, pulmonary radiological findings, and markers for macrophage activation (angiotensin converting enzyme) and lymphocyte activation (beta 2 microglobulin) were not correlated with bronchoalveolar lavage fluid hyaluronate. It was concluded that in sarcoidosis release of hyaluronate into the airways is related to lung volume and therefore to the course of the disease. Increased synthesis of hyaluronate in lung parenchyma may reflect activation of fibroblasts, and measurements of hyaluronate may have clinical value for prognosis and treatment.

Adult↗

Post-operative substrate utilisation and gas exchange using two different TPN-systems: glucose versus fat.

Twenty patients were studied over the first 4 post-operative days following abdominal aortic surgery. Ten patients had 93% of their non-protein energy as glucose and insulin was given to keep blood glucose below 10 mmol/l. The other 10 patients had 80% of non-protein energy as fat (Intralipid). Amino acids corresponding to 12 g of nitrogen were given in both groups. Gas exchange, nitrogen balance, phosphate balance, vanillylmandelic acid (VMA) excretion, 1- and 3-methylhistidine in urine, acute phase proteins, immunoglobulins and albumin were followed. Substrate utilisation was calculated from indirect calorimetry data and nitrogen excretion. Metabolism in the early post-operative phase was found to adapt to the nutrition regimen given even though the composition was extreme either in fat or carbohydrate content. The glucose-insulin regimen had a better nitrogen sparing effect and based on the difference in 3-methylhistidine excretion it is suggested that mainly protein muscle benefitted from this. Regardless of the TPN-regimen given, those patients whose RQ deviated the most from the average in their group had the highest nitrogen excretion. The two groups showed no differences in plasma proteins and catecholamine excretion.

Journal Article↗

Isolation of human alveolar macrophages and lymphocytes from bronchoalveolar lavage fluid by centrifugal elutriation.

Cell populations obtained by bronchoalveolar lavage (BAL) from humans showed varying proportions of lymphocytes and macrophages, about 5% and 94%, respectively, in healthy controls (n = 12), and about 24% and 75%, respectively, in patients with sarcoidosis (n = 13). The present study was carried out to examine centrifugal elutriation as a means to obtain from human BAL fluids highly purified populations of viable cells, required for further biochemical investigations. After centrifugation of BAL fluids at 400 g for 5 min, cells were resuspended in Hank-Tris solution, loaded into a Beckman elutriator rotor (rotor speed 2800 rpm) and elutriated with Hank-Tris in approximately 10 min. Cells were collected at flow rates of 20 ml/min (fraction I), 32 ml/min (fraction II) and, after stopping the rotor, 80 ml/min (fraction III). Fraction I contained mainly lymphocytes, about 54% and 74% in controls and sarcoidosis, respectively. Fraction III consisted almost solely of macrophages, while fraction II contained mixed populations. Total cell recovery was about 74% and 55% in controls and sarcoidosis, respectively. Half of the missing cells were lost during centrifugation, the rest during elutriation. Cell viability was 85-90% after the first centrifugation. Following elutriation, the viability was found unchanged in fraction III, but decreased to about 50% in fraction I of controls. The decrease may be due to the accumulation of dead cells with decreased density in this fraction. The results showed that centrifugal elutriation is a highly suitable technique for the isolation of macrophages from human BAL fluids. Enriched lymphocyte populations may be obtained from sarcoid BAL fluids.

Bronchi↗

Effects of a thermal ceiling on postoperative hypothermia.

Moderate per- and postoperative hypothermia initiates an increased metabolism in the postoperative period. The subsequent demands on oxygen transport may be critical in poor risk patients. Nineteen healthy young women with moderate hypothermia after abdominal surgery were studied for 2 h postoperatively with or without external heating from a heating ceiling. Central and peripheral temperatures, oxygen consumption, plasma catecholamines and shivering were measured. A method for continuous measurement of oxygen consumption and carbon dioxide production during spontaneous breathing is described. The results suggest that postoperative external heating decreases oxygen consumption, shivering and plasma catecholamine levels. At the same time, the comfort of the patient is increased considerably.

Adult↗

Thermal balance during transurethral resection of the prostate. A comparison of general anaesthesia and epidural analgesia.

Heat loss during anaesthesia and surgery is a common problem. In patients with restricted cardio-pulmonary reserves this may endanger the postoperative outcome. In order to compare thermal balance we studied 25 men undergoing transurethral resection of the prostate (TURP), using either general anaesthesia (G.A.) or epidural analgesia (E.A.). Oxygen uptake, catecholamines, peripheral and central temperatures were followed in the per- and postoperative period. Heat production and total body heat were calculated from oxygen uptake and temperature measurements, respectively. Transurethral resection of the prostate resulted in a peroperative heat loss which was not influenced by the anaesthetic technique used and averaged 370 kJ during the first hour of surgery. G.A. reduced heat production while this was uninfluenced by E.A. After termination of general anaesthesia, oxygen uptake and plasma catecholamines increased, while no such changes could be detected using epidural analgesia. The ability to increase mean body temperature by increasing heat production was negatively correlated to age.

Age Factors↗

Dissolution of metals by human and rabbit alveolar macrophages.

The ability of human and rabbit alveolar macrophages to dissolve 0.1-0.5 micron MnO2 particles in vitro was compared. The amount of Mn added and dissolved from the particles over periods of nought, one, and three days was determined by flame atomic absorption spectrophotometry. The amount dissolved by human and rabbit macrophages was similar; on average 43.1% and 43.9%, respectively, were dissolved within three days. But rabbit and human macrophages dissolved significantly more Mn than was dissolved in the respective culture medium without macrophages after one and three days. It is suggested that the dissolution of particles by alveolar macrophages should be one basic component in any model of alveolar clearance of inorganic particles.

Adult↗

Kveim test reactivity in Melkersson-Rosenthal syndrome (cheilitis granulomatosa).

The relation between the Melkersson-Rosenthal syndrome (MRS) and sarcoidosis is unclear. The Kveim test, a test for sarcoidosis, was performed in seven patients, two with complete and five with abortive forms of Melkersson-Rosenthal syndrome. All were found to be negative. Serum levels of angiotensin converting enzyme and calcium were normal. These facts make it unlikely that MRS is a type of sarcoidosis.

Adult↗

Kveim test and mitochondrial antibodies in the differential diagnosis between primary biliary cirrhosis and sarcoidosis.

Intracutaneous Kveim test and measurement of serum mitochondrial antibodies were performed in a group of patients with primary biliary cirrhosis (PBC) and in a group of patients with sarcoidosis. There were 14 patients, 1 man and 13 women, age range 39-64 years, with clinical picture, laboratory tests and liver biopsy consistent with PBC. In the sarcoidosis group there were 38 patients, 18 men and 20 women, age range 22-76 years, with clinical, radiological and histopathological findings typical for sarcoidosis. In this group chest x-ray showed stage 0 in 3 patients, stage I in 7, stage II in 18 and 10 patients were in stage III. Kveim test was positive in 24 (63.2%) of the sarcoid patients and negative in all 14 patients with PBC. Mitochondrial antibodies were present in 13 of the PBC-patients but in none of the 38 examined sarcoid patients. Kveim test and analysis of mitochondrial antibodies seems to be of great value in the differential diagnosis between primary biliary cirrhosis and sarcoidosis.

Adult↗

Prevalence of bronchial asthma and chronic bronchitis in a community in northern Sweden; relation to environmental and occupational exposure to sulphur dioxide.

The prevalence of chronic bronchitis and bronchial asthma has been studied in a community in northern Sweden, where the major air pollutant is sulphur dioxide (SO2) from a sulphite pulp factory. In the town the annual mean winter concentration of SO2 during the years 1975-1979 was 20-40 micrograms SO2/m3 air. A questionnaire concerning respiratory symptoms was distributed to all individuals (2374) within the age group 16-72 years, and was answered by 2203 individuals (93%). Bronchial asthma was found in 78 (3.5%) individuals, chronic bronchitis in 57 (2.6%) and both diagnoses in 3 individuals (0.1%). There was a statistically significant relationship between presence of chronic bronchitis and sex, age, smoking and employment at the sulphite pulp factory. Sulphur dioxide exposure at the factory apparently acted synergistically with smoking in increasing the relative risk for chronic bronchitis in smoking employees compared to non-smoking non-employees. However, our results indicate no excess risk of chronic bronchitis in a population with long-term environmental exposure to SO2 in concentrations between 20-40 micrograms, when the concentration of other air pollutants is low.

Adolescent↗