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Biomedical subjects

A Larsson

Publications and source records attributed to A Larsson.

At least 217 records · Page 12Linked to original sources

Dosimetric properties of a scanned beam microtron at low monitor unit settings: importance for conformal therapy.

The dosimetric stability, linearity, dose rate dependence, and flatness of both photon and electron beams have been evaluated for a racetrack microtron at low monitor unit settings. For photons, the variation in dosimetric output about the mean is < 0.4% at 100 monitor units (MU), < 1% at 10 MU, and < 4% at 2 MU. The output dependence on the dose rate varied by < 0.6% between 85-300 MU/min. Flatness and symmetry for the 25- and 50-MV beams showed deviations of < 3% at both dmax and 10-cm depths, and only slightly > 3% at 20 cm, even at only 3 MU, in contrast with other scanned beam accelerators. Broad electron beams on the microtron are created by the superposition of the elementary beam pulses either directly from the scan magnets, or after their broadening through a scattering foil. The dosimetric instability both with and without the foil was less than 0.6% for both the 25- and 50-MeV electrons. Dose nonlinearity was < 1% above 10 MU. Field flatness was determined for scan matrices designed to produce a flat field both with and without a scattering foil. Symmetry and flatness deviations were < 3% for both electron energies when a scattering foil was used, even for a single scan. The variation of the electron dose per monitor unit between dose rates of 85-300 MU/min was < 1% (25 MeV) and < 4% (50 MeV) when a scattering foil was used, but as high as 22% (25 MeV) and 36% (50 MeV) for broad beams generated by elementary beam pulses directly from the scanning magnets. The microtron exhibits dosimetric properties which fulfill the recommendations of Task Groups 21 and 25. Based on the stability of the scanned beam at low monitor unit settings, the microtron can be used for 3-D conformal therapy with both photons and electrons.

Biophysical Phenomena↗

Electron dose profile shaping by modulation of a scanning elementary beam.

The use of multiple high energy electron beams has been limited in the treatment of deep seated tumors. This is principally because of the rapid increase in the physical electron beam penumbra as a result of the rise in large angle scattering with depth in the patient. This decreases the transverse dose gradient between the target volume and sensitive dose limiting structures and diminishes the ability to conform electron isodose lines to the target volume. If the beam is flat in air, then its profile will become progressively more rounded with depth, due to the increase of scatter out of the beam edges. With a scanning elementary electron beam, such as produced by the Microtron MM50, the characteristics of a broad beam profile are determined by the scan pattern. Using an appropriate scan pattern one can create, at any depth within the range of electrons, various dose profiles with the sharpness not exceeding that of the elementary beam. The objective of this work was to study methods that produce the desired electron beam profile at the depth of the target volume, and to derive the surface fluence profile required. Two approaches were explored to modulate the elementary beam distribution: "amplitude modulation" (AM) and "frequency modulation" (FM). We calculated coordinate and intensity distributions of the 25, 40, and 50 MeV elementary beam pulses at the surface that would yield a flat field at various prescribed depths. The results are in good qualitative agreement with iterative deconvolution calculations by Brahme et al. [Acta Radiol. Oncol. 19, 305-319 (1980)]. The scattering penumbra between the 50%-90% isodose lines can be reduced by up to 40% by beam modulation. The modulation should also enable the combination of multiple electron beams so as to achieve the desired conformal isodose profile as is customarily seen with photon beam planning, but with greater normal tissue sparing due to higher electron longitudinal depth--dose gradients. The results can be also used for electron accelerators that do not use a scanning elementary beam.

Algorithms↗

Changes in lung volume and static expiratory pressure-volume diagram after surfactant rescue treatment of neonates with established respiratory distress syndrome.

The effect of natural surfactant on respiratory system mechanics in infants with respiratory distress syndrome (RDS) is incompletely understood, possibly because the analysis has usually been confined to the tidal breath. We studied 11 paralyzed neonates weighing 540 to 1,850 g before and approximately 30 min after surfactant, which was instilled at 4 to 41 h of age. Diagrams relating airway pressure to expired volume were obtained by having the infant exhale passively through a flowmeter, starting at 30 and ending at 0 cm H20 of pressure. An interrupter intermittently stopped the flow so that pressure could be recorded under static conditions. FRC was measured by sulfur hexafluoride washout, and TLC was calculated from FRC and the pressure-volume (P-V) curve. Ventilation homogeneity was assessed from the washout curve as pulmonary clearance delay (PCD). TLC increased by 10% or more in five infants, but it remained unchanged in the others. Median TLC was 19 ml/kg before and 21.5 ml/kg after surfactant (p = 0.39). The P-V curve became markedly steeper at low pressures after surfactant in most infants, the slope of the steepest segment, i.e., maximal compliance, increasing from 0.65 to 1.22 ml/cm H20/kg (medians, p = 0.008). Dynamic compliance (Cdyn) was unchanged at 0.28 ml/cm H20/kg, whereas specific dynamic compliance (Cdyn/FRC) decreased (p = 0.04). There was no significant immediate change in PCD. The findings imply that during the first 30 min surfactant acted mainly by stabilizing already ventilated air spaces.

Biological Products↗

Lung volumes and pressure-volume relations of the respiratory system in small ventilated neonates with severe respiratory distress syndrome.

Total lung capacity (TLC), inspiratory capacity (IC), functional residual capacity (FRC), and deflation pressure-volume (P-V) curves were studied in 16 intubated neonates (540-3300 g), 10 with severe respiratory distress syndrome (RDS) and 6 air-ventilated with normal chest radiograms. FRC was measured using washout of a tracer gas (sulfur hexafluoride), and TLC and IC were calculated after inflating the lungs to 30 cm H2O. P-V curves were obtained during expiration from TLC using an interrupter technique, and the steepest slope of the curve, i.e. the maximum compliance (Crs-max), was calculated. In addition, an index of ventilation inhomogeneity (pulmonary clearance delay, PCD) was computed from the shape of the SF6 washout curve. TLC/body weight was less in the RDS group than in the air-ventilated group (median 19 and range 16-43 mL/kg versus 48 and 43-52 mL/kg, respectively; p < 0.01), mainly because of a marked reduction in IC (median 11 and range 8-24 mL/kg versus 29 and 28-40 mL/kg; p < 0.01). The flatter P-V curve in the RDS group was reflected also in a lower Crs-max (median 0.7 and range 0.4-1.7 cm H2O-1 kg-1) than in the air-ventilated group (2.3 and 2.0-3.1 mL cm H2O-1 kg-1, respectively; p < 0.01). Thus, there was no overlap in IC or Crs-max between the groups, suggesting that reductions in these measures may be main characteristics of RDS. On the other hand, no difference in PCD was found, indicating that, in infants with RDS, the tidal volume is distributed fairly homogeneously to the ventilated parts of the lungs.

Functional Residual Capacity↗

Flare-up at contact allergy sites in a gold-treated rheumatic patient.

Contact allergy to gold sodium thiosulfate and gold sodium thiomalate was established by skin testing in a rheumatic patient intended for gold therapy. An intramuscular test dose of gold sodium thiomalate (Myocrisin) induced a flare-up of previously positive epicutaneous and intradermal test reactions, with a histological and immunohistochemical picture compatible with an allergic contact dermatitis. Since gold allergy is frequent, the cutaneous side-effects of gold therapy ("gold dermatitis") may be explained by such an immunopathological reaction.

Antirheumatic Agents↗

Gastrointestinal transit of amoxicillin modified-release tablets and a placebo tablet including pharmacokinetic assessments of amoxicillin.

BACKGROUND: We have investigated the gastrointestinal transit time of, the influence of food intake on, the disintegration of, and the pharmacokinetics of amoxicillin in a modified-release form. METHODS: Radiolabelled modified-release tablets of amoxicillin and placebo tablets were administered, in an open three-way, randomized, crossover design, as single doses during omeprazole treatment, to six male healthy subjects during fasting and non-fasting conditions. Radioscintigraphic images and plasma samples were obtained. RESULTS: The estimated mean (and range) gastric emptying time of the modified-release tablet after drug administration was 0.3 h (0.1-1.0 h) during fasting conditions, 4.3 h (1.7-5.0 h) after a light breakfast, and 4.9 h (1.9-18.0 h) after a heavy breakfast. The small-intestinal transit time during fasting conditions was 4.7 h (2.9-6.9 h) and was not significantly changed after light or heavy breakfast intake. The relative bioavailability of the modified-release tablet was 55%, compared with a commercially available amoxicillin immediate-release tablet. CONCLUSION: The modified-release tablet of amoxicillin administered postprandially apparently increases the amoxicillin release time in the stomach. The relevance of its use for anti-H. pylori treatment can be questioned.

Adult↗

Experimental graft versus host disease in the (BN x LEW) F1 rat hybrid as a model for autoimmune disease. Study of early adenitis in lacrimal and salivary glands.

We analysed inflammatory changes at selected time intervals, of salivary and lacrimal glands in the developing immunostimulatory [BN-->(BN x LEW)F1] model of graft-versus-host (GVH) reaction. A focal mononuclear adenitis in lacrimal and salivary glands developed at day 7 and increased clearly in "onset"-rats. Inflammatory responses in submandibular and parotid glands were less consistent and weaker than in lacrimal glands. There was no significant focus score difference between males and females. The lacrimal infiltrates were characterised immunohistochemically with monoclonal antibodies. Our findings indicate that CD4+ cells of donor origin dominated infiltrates, whereas a moderate number of B cells appeared only in large (late) foci. At stages corresponding to the onset of GVH disease (GVHD) in skin/labial mucosa, numerous CD8+ lymphocytes and NK cells were found in lacrimal glands, adjacent to ductal/ vascular plexa, sometimes forming small foci and with evidence of epithelial damage. We conclude that GVHD-associated T cell migration into rat exocrine glands occurs as a result of the semi-alloantigen-activated phenotype properties of the T cells. This activation occurs initially in lymphoid tissue and migration into glands is secondary to this and unrelated to antigen specificity. We also found evidence of amplification and tissue damage, interpreted as due to local reactivation of the T cells.

Animals↗

Changes in permeability of sheep's lungs by oleic acid are dose dependent.

OBJECTIVE: To evaluate a two-isotope technique to detect graded changes in pulmonary microvascular permeability. DESIGN: Open experimental study. SETTING: University hospital, Sweden. MATERIAL: Fifty-seven sheep. INTERVENTIONS: Catherisation of one carotid artery, pulmonary artery and central vein. Control group 1 (n = 10), control group 2 (n = 12) had an additional pulmonary artery balloon catheter inserted, experimental group 3 (n = 9) was given oleic acid 0.005 mg kg-1 BW, experimental group 4 (n = 12) received oleic acid 0.02 mg kg-1 BW and experimental group 5 (n = 11) 0.05 mg kg-1 BW. Groups 3-5 had all PA catheters. All animals were intubated and ventilated artificially. Duration of experiments was 6 hours. OUTCOME MEASURES: Transferrin was labelled in vivo with 113mIn chloride and erythrocytes with 99mTc following injection of stannous chloride. External gamma counting was corrected for background, decay and scatter. Blood activity was used as reference. Normalised slope index (NSI) and transferrin leak index (TLI) were calculated as measures of pulmonary microvascular permeability. RESULTS: A graded response in both NSI and TLI was found. Insertion of the PA catheter (group 2) significantly increased NSI from (group 1) (1.4 (0.1)) 10(-4) min-1 to (11 (2)) 10(-4) min-1 (p < 0.05). TLI increased significantly from (9 (2)) 10(-4) min-1 to (72 (13)) 10(-4) min-1. Oleic acid increased NSI significantly to (13 (1)) 10(-4) min-1, (32 (2)) 10(-4) min-1 and (61 (5)) 10(-4) min-1 in groups 3-5, respectively. Corresponding values for TLI were (95 (13)) 10(-4) min-1, (162 (6)) 10(-4) min-1 and (228 (26)) 10-4 min-1, respectively. CONCLUSION: The double-isotope technique of external monitoring of permeability changes to protein in the lungs was sensitive to pick up graded increments in leakage, related in a dose-dependent way to lung injury.

Animals↗

Characterization of the binding of YO to [poly(dA-dT)]2 and [poly(dG-dC)]2, and of the fluorescent properties of YO and YOYO complexed with the polynucleotides and double-stranded DNA.

The interaction between the fluorescent dye YO (oxazole yellow) and the alternating polynucleotides [poly(dA-dT)]2 [the duplex of alternating poly(dA-dT)] and [poly(dG-dC)]2 [the duplex of alternating poly(dG-dC)] has been studied with optical spectroscopic techniques including absorbance, flow linear dichroism, CD, and fluorescence measurements. The principal features of the spectra are very similar for the two polynucleotide solutions, showing that YO binds quite similarly to AT and GC base pairs. From a strongly negative reduced linear dichroism (LDr) in the dye absorption band, an induced negative CD, and transfer of energy from the bases to bound YO, we conclude that at low mixing ratios YO is intercalated in both [poly(dA-dT)]2 and [poly(dG-dC)]2. At higher mixing ratios an external binding mode starts to contribute, evidenced from the appearance of an exciton CD. The conclusion that YO binds in a similar way to AT and GC base pairs should be valid also for the dimer YOYO since its YO units have been found to bind to double-stranded (dsDNA) in the same way as the YO monomer. The fluorescence properties of YO and YOYO complexed with DNA or the polynucleotides have been characterized by studying the dependence of fluorescence intensity on temperature, mixing ratio, and ionic strength. The fluorescence intensity and fluorescence lifetime of YO-DNA decrease strongly with increasing mixing ratio, whereas the fluorescence intensity of YOYO-DNA shows a weaker dependence, indicating that the quantum yield depends on the distance between the YO chromophores on the DNA chain. Further, the fluorescence intensity of YO depends on the base sequence; the quantum yield and fluorescence lifetime for YO complexed with [poly(dG-dC)]2 are about twice as large as for YO complexed with [poly(dA-dT)]2. Measurements of excitation spectra at different mixing ratios and different emission wavelengths indicate that the fluorescence of the externally bound chromophores is negligible compared to the intercalated ones.

Benzoxazoles↗

Mononuclear cell thyroiditis in rats with graft-versus-host disease.

Rats with graft-versus-host disease (GVHD), induced by injecting spleen cells of parental strain rats (Brown Norway) into non-irradiated (Brown Norway x Lewis) F1 hybrid rats, develop thyroiditis. This is characterized by mononuclear cell infiltration with destruction of the epithelium and a significant reduction in serum thyroid hormone levels. Immunohistochemically, the mononuclear cells consisted mainly of CD8-positive cells and macrophages. These findings provide evidence that the thyroid gland can now be enumerated as one of the target organs during GVHD. The CD8-positive cells may serve as important effector cells in lesion development, either by direct cytotoxicity or by supporting the cytotoxic potential of macrophages.

Animals↗

Biochemical and physiological effects in fish exposed to bleached kraft mill effluents.

The studies were performed on perch (Perca fluviatilis) caught outside Husum and Iggesund kraft pulp mills in 1985 and 1987, respectively, and the results were compared to previous observations from 1984 to 1985 in the receiving waters of the Norrsundet kraft pulp mill. The studies revealed that the biochemical and physiological variables, i.e., EROD activity, gonad size, number of lymphocytes, carbohydrate metabolites, and plasma ion composition, can be used as sensitive and reliable indicators of toxic effects on natural populations of fish exposed to conventional chlorine-bleached kraft mill effluents. However; the effects were generally less pronounced and indicated less geographic extension than those seen in perch previously investigated in the receiving waters of the Norrsundet kraft pulp mill. Based on these studies on perch at Husum and Iggesund and the previous studies at Norrsundet it can be concluded that the chlorine-bleached kraft mill effluents cause serious disturbances to vital biochemical and physiological functions, which can affect the health status and presumably also the survival of the fish. Finally, the responses do not reflect the present situation in the receiving waters since all three mills have taken extensive measures for process alterations and discharge reductions after the time of the investigations.

Animals↗

Different ventilatory approaches to keep the lung open.

OBJECTIVES: To study the ability of different ventilatory approaches to keep the lung open. DESIGN: Different ventilatory patterns were applied in surfactant deficient lungs with PEEP set to achieve pre-lavage PaO2. SETTING: Experimental laboratory of a University Department of Anaesthesiology and Intensive Care. ANIMALS: 15 anaesthetised piglets. INTERVENTIONS: One volume-controlled mode (L-IPPV201:1.5) and two pressure-controlled modes at 20 breaths per minute (bpm) and I:E ratios of 2:1 and 1.5:1 (L-PRVC202:1 and L-PRVC201.5:1), and two pressure-controlled modes at 60 bpm and I:E of 1:1 and 1:1.5 (L-PRVC601:1 and L-PRVC601:1.5) were investigated. The pressure-controlled modes were applied using "Pressure-Regulated Volume-Controlled Ventilation" (PRVC). MEASUREMENTS AND RESULTS: Gas exchange, airway pressures, hemodynamics, FRC and intrathoracic fluid volumes were measured. Gas exchange was the same for all modes. FRC was 30% higher with all post-lavage settings. By reducing inspiratory time MPAW decreased from 25 cmH2O by 3 cmH2O with L-PRVC201.5:1 and L-PRVC601:1.5. End-inspiratory airway pressure was 29 cmH2O with L-PRVC201.5:1 and 40 cmH2O with L-IPPV201:1.5, while the other modes displayed intermediate values. End-inspiratory lung volume was 65 ml/kg with L-IPPV201:1.5, but it was reduced to 50 and 49 ml/kg with L-PRVC601:1 and L-PRVC601:1.5. Compliance was 16 and 18 ml/cmH2O with L-PRVC202:1 and L-PRVC201.5:1, while it was lower with L-IPPV201:1.5, L-PRVC601:1 and L-PRVC601:1.5. Oxygen delivery was maintained at pre-lavage level with L-PRVC201.5:1 (657 ml/min.m2), the other modes displayed reduced oxygen delivery compared with pre-lavage. CONCLUSION: Neither the rapid frequency modes nor the low frequency volume-controlled mode kept the surfactant deficient lungs open. Pressure-controlled inverse ratio ventilation (20 bpm) kept the lungs open at reduced end-inspiratory airway pressures and hence reduced risk of barotrauma. Reducing I:E ratio in this latter modality from 2:1 to 1.5:1 further improved oxygen delivery.

Analysis of Variance↗

Human dental pulp and gingival tissue after static magnetic field exposure.

The aim of this intra-individual study was to examine human dental pulp and gingival tissue after exposure to static magnetic fields generated by orthodontic samarium-cobalt magnets. In seven individuals, aged between 11.5 and 17.5 years, the maxillary first premolars and immediately adjacent gingival tissues were exposed to a static magnetic field from a bonded magnet on one side (test) and a demagnetized magnet was used as a control on the contralateral side. After a period of 8 weeks the test and control teeth were clinically examined regarding gingival conditions, then biopsies of the buccal gingival tissues were taken and the maxillary first premolars were extracted. The teeth and the tissue biopsies were examined histologically. The static magnetic field exposure (flux density) of the coronal pulp sections on the test sides ranged between 100 and 150 Gauss, and the exposure of the buccal gingival tissues ranged between 200 and 900 Gauss. The contralateral control tissues were exposed to flux density values at the level of the natural magnetic field on earth (0.3-0.6 Gauss). Static magnetic fields produced by orally placed orthodontic rare earth magnets did not result in any change in human dental pulp or gingival tissue adjacent to the magnets. There was no difference in clinical gingival conditions between test and control sites.

Adolescent↗

The histopathology of oral mucosal lesions associated with amalgam or porcelain-fused-to-metal restorations.

OBJECTIVES: To analyse the interface stomatitis patterns of oral lichenoid lesions in contact with amalgam and to compare these with the histologic changes in oral lesions clinically associated with porcelain-fused-to-metal (PFM) restorations. To relate these features to the presence of tissue-bound mercury (Hg). DESIGN: A retrospective analysis of tissue biopsies, with clinical data collected via a complementary questionnaire. SUBJECTS AND METHODS: 479 biopsies diagnosed in 1987 as 'lichenoid reactions'. From these, we retrieved all with amalgam contact and without candida or medication. From 1990-91, all mucosal lesions stated to be associated with PFM restorations were then retrieved for comparative analysis. The biopsies were examined with routine histologic and autometallographic methods. RESULTS: 77 amalgam-associated lesions were found and could be subdivided into five pre-defined interface stomatitis types. We found 22 lesions associated with PFM and 20 showed histopathologic features similar to those associated with amalgam. Hg accumulations were detected in the majority of amalgam-associated but only in part of the PFM-associated lesions. CONCLUSIONS: Amalgam-associated lichenoid lesions present a wide spectrum of histopathologic patterns, corresponding to similar patterns in dermatopathology but with no evidence of association with specific disease. PFM-associated lesions tend to display similar lichenoid features, suggestive of common pathogenetic mechanisms. Hg accumulations may play a role to maintain the chronicity of such lichenoid lesions.

Adolescent↗

Dynamics of carbon dioxide elimination following ventilator resetting.

BACKGROUND: Carbon dioxide elimination (VCO2) at steady state corresponds to the metabolic rate. A change in tidal ventilation will lead to a transient response in VCO2 if other determinants of VCO2 are constant. This principle may be applied in the critical care unit to reset ventilators. OBJECTIVE: To define and characterize the transient response of VCO2 to a well-defined change in ventilation. METHODS: Forty-four patients in stable condition receiving volume-controlled mechanical ventilation had trend recordings of ventilator pressures, flow, volumes, VCO2, and end-tidal CO2 (ETCO2) for 20 min. At time t0, the minute ventilation was either increased (n = 22) or decreased (n = 22) by 10% after which these parameters were monitored over 30 min. Blood gas values were measured 5 and 20 min after the change in ventilation and the dead space fractions were computed using the single breath-CO2 test. DATA ANALYSIS: The first ten breaths (till t1) after a change in ventilation were excluded. The time constant (tau) of the relative change in VCO2 (delta VCO2) was calculated by fitting exponential regressions to delta VCO2 for periods up to 20 min after t1. RESULTS: The delta VCO2 at t1 was proportional to the relative change in tidal volume (delta VT). The proportionality decreased gradually during 20 min. The proportionality of the relative change in ETCO2 (delta ETCO2) or PaCO2 (delta PaCO2) with delta VT was minimal at t1 and increased during the 20 min. tau increased progressively when calculated over longer periods (p < 0.001). tau was similar in the groups with increased and decreased ventilation up to 5 min, after which it was longer in the group with decreased ventilation (p < 0.05). The delta PaCO2 after 20 min correlated best with delta VCO2 at t1 (r = -0.8) and with delta ETCO2 at the end of 20 min (r = 0.8). CONCLUSIONS: Noninvasively monitored VCO2 provides an instantaneous indication of the change in alveolar ventilation in well-sedated, mechanically ventilated patients in stable condition without significant cardiopulmonary disease.

Adult↗