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Biomedical subjects

A M Worm

Publications and source records attributed to A M Worm.

At least 91 records · Page 5Linked to original sources
PubMed1981

Exchange of macromolecules between plasma and skin interstitium in extensive skin disease.

The concentrations of albumin, transferrin, IgG and alpha 2-macroglobulin were measured in serum (C8) and in blister fluid (Cb) from lesional skin obtained by suction in 11 patients with extensive skin disease. The results were compared with those of 10 matched control subjects. In the patients the Cb/C8 ratios and the distribution ratios (i.e., intravascular to total masses) of the 4 proteins and that of inulin were correlated to the corresponding molecular weights. The distribution ratios of the proteins were calculated from plasma volume (PV), C8, Cb and extracellular fluid volume (ECV) determined with inulin, and that of inulin as PV/ECV. The distribution ratio of albumin was similar to that obtained from a long-term metabolic turnover study. It is concluded that the sieving properties of the dermal vascular endothelium is maintained during suction also in patients with extensive skin disease and that the blister fluid equals "average" interstitial fluid. The transcapillary escape rate (TER) of albumin and IgG (i.e., fractions of intravascular masses of albumin and IgG passing to the extravascular space per unit time) and the accumulation rate of i.v. injected 131I human serum albumin and 125I-IgG in the blister fluid was significantly increased in the patients. The latter was increased 2 to 3-fold. It is shown, that the increased extravasation of plasma proteins from the skin microvasculature accounts fully for the increased escape rates as measured in whole man, of albumin as well as IgG.

Blood Proteins↗
PubMed1981

Plasma and interstitial fluid volume in extensive skin disease.

Plasma volume and extracellular fluid volume were determined simultaneously in 17 patients with extensive skin disease and 18 matched normal subjects after an intravenous bolus injection of 131I-labeled human serum albumin and inulin. The patients had a decrease in plasma volume (-6%), which, however, was statistically significant only when related tao body weight or surface area. There was a concomitant increase in extracellular fluid volume (+7%) and interstitial fluid volume (+12%). These deviations from control data were statistically significant neither in absolute values nor when related to body size. Interstitial fluid volume was calculated as the difference between extracellular fluid volume and plasma volume. The mean plasma volume: interstitial fluid volume ratio was significantly lower in the patients (0.35 +/- 0.05 SD) than in the control group (0.42 +/0 0.05 SD) (p < 0.001). These results show that a shift of fluid from the intra- to the extracellular spaces is present in patients with extensive skin disease. Elevated microvascular water filtration in the skin is suggested as a major mechanism of this abnormal fluid distribution.

Body Water↗
PubMed1981

Increased microvascular water filtration and blood flow in extensive skin disease.

The rate of microvascular fluid transfer was estimated in 11 patients with extensive skin disease from the capillary filtration coefficient as measured by strain-gauge plethysmography on the forearm. Capillary filtration of the patients was significantly increased when compared with the control group (p < 0.001). Blood flow was increased to the same extent as capillary function, thus resulting in a normal mean ratio between the capillary filtration coefficient and the blood flow. On this background it is concluded that an increased capillary surface area available for exchange of fluid can explain the increased microvascular water filtration.

Adult↗
PubMed1981

Distribution and degradation of albumin in extensive skin disease.

The distribution and degradation of albumin were determined in twelve patients with extensive skin disease and in ten control subjects by measuring the metabolic turnover and transcapillary escape of 132 I-labelled albumin. The ratio of intravascular to total mass of albumin was normal. Thus the observed hypoalbuminaemia and the low intravascular mass reflect a reduced mass of total body albumin. The rate of synthesis was normal, but the transcapillary escape rate reflecting the microvascular leakiness to macromolecules, and the fractional disappearance rate were significantly higher in the patients than in the controls (P less than 0.001). It is concluded that the hypoalbuminaemia in these patients is the result of an increased endogenous catabolism of albumin without significant loss via urine, stools or skin. A positive correlation between the transcapillary escape rate and fractional catabolic rate of albumin supports the concept of a causal relationship between these parameters.

Adult↗
PubMed1981

Interstitial fluid: exchange of macromolecules between plasma and skin interstitium.

Fluid was collected from blisters developed by suction on the abdominal skin in ten normal volunteers. During the same study the transcapillary escape rate of intravenously injected 131I-albumin and 125I-IgG together with the accumulation of these tracers in the blister fluid was measured. The ratios between the concentrations of endogenous albumin, transferrin, IgG and alpha 2-macroglobulin in the blister fluid (Cb) and serum (Cs) correlated directly with the free diffusion coefficients indicating that the sieving properties of the vascular endothelium remained intact during the suction. The ratios of intravascular to total masses of the four endogenous proteins calculated from plasma volume, Cs, Cb and extracellular fluid volume determined with inulin and Cb were very similar to those obtained in long-term metabolic turnover studies. The ratio between the accumulated IgG and albumin tracers in the blister fluid (0.80) was identical with the Cb/Cs ratio between endogenous IgG and albumin (0.78) but higher than the ratio between the IgG and albumin escape rates from the total microvasculature (0.58). From the protein tracer determinations it cannot be definitely excluded that suction increases the microvascular escape rates. If the distribution volume of inulin equates that of albumin in steady-state it can, however, be concluded from the data given on the endogenous plasma protein, that blister fluid from the abdominal skin corresponds to average interstitial tissue fluid.

Adult↗
PubMed1981

Capillary microscopy of the nailfold in psoriatic and rheumatoid arthritis.

The nailfold capillaries of 35 patients with psoriatic arthritis and 30 with rheumatoid arthritis were studied by capillary microscopy and the findings compared. Seventy healthy subjects served as controls. The pronounced subpapillary plexus visibility, greater number of vessels and their elongation are indicative of rheumatoid arthritis, while shorter, fewer capillaries and especially characteristic psoriatic capillaries, when present, suggest psoriatic arthritis. Sluggish blood flow, higher number of hemorrhages and higher subpappillary plexus visibility are common to both patient groups as opposed to the controls.

Arthritis↗
PubMed1981

Studies on gastrointestinal plasma protein loss in extensive skin disease.

The gastrointestinal loss of plasma protein was determined in 9 patients with extensive skin disease. 51CrCl3 was used as the test substance in 5 patients and [131I]albumin in 4 patients. The fecal isotope excretion was within the normal limits in all patients, though they had hypoalbuminaemia and increased initial disappearance rate of tracer albumin, presumably reflecting an abnormal leakiness of the microvasculature. It is concluded that loss of albumin through the gut does not account for the depressed plasma albumin concentration in these patients.

Adult↗
PubMed1980

Microvascular protein leakage in extensive skin diseases: aspects of the transport mechanisms.

The transcapillary escape rates of albumin (TERalb) and IgG (TERIgG) (i.e. fractions of intravascular masses of albumin and IgG passing to the extravascular spaces per unit time) can be used as parameters of the microvascular leakiness to macromolecules. These parameters were examined simultaneously in 12 patients with extensive skin disease. Six of the patients were reexamined after treatment with systemic steroid. The significantly increased (p less than 0.001) pretreatment values of both TERalb and TERIgG were normalized after treatment with systemic steroid to mean values comparable to those of the control group (p greater than 0.1). The patients mean ratio of TERIgG/TERalb did not differ from that of controls, neither before nor after treatment (p greater than 0.1). The microvascular leakage to differently sized macromolecules in the patients examined seems to be independent of the underlying skin disease. On the background of the structural microvascular changes often described in inflammatory reactions developed experimentally, and the similar changes present in the microvasculature of the psoriatic skin, it is suggested, that the increased microvascular leakage as found in this study, is confined to the postcapillary venules. The functional mechanisms dominating the transport of macromolecules across the vessel wall in this study are compatible with free diffusion as well as with filtration.

Adult↗
PubMed1980

Microvascular leakage of plasma proteins after short-term PUVA treatment.

The transcapillary escape rate of albumin (TERalb) i.e., the fraction of intravascular albumin, that passes to the extravascular space per unit time is a parameter of the leakage of macromolecules from the total microvasculature. In this study TER alb was measured before and after PUVA treatment to psoriatic patients to study functional alterations in the microvasculature induced by the treatment. Short-term PUVA treatment caused a statistically significant increase in TERalb in 7 out of 8 patients (p less than 0.05). This seems to be a functional equivalent to the morphological changes in the dermal capillary of psoriatic skin and the ultrastructural changes in the dermal vessel walls described after PUVA treatment. It suggests, that the amorphous perivascular masses described in the psoriatic skin after PUsult of increased vascular permeability.

Adolescent↗
PubMed1980

Psoriatic arthritis treated with oral zinc sulphate.

Twenty-four patients suffering from psoriatic arthritis participated in a double blind cross-over trial of peroral zinc sulphate versus placebo (Trial I). Eleven patients continued an open trial of peroral zinc sulphate for an additional 24 weeks (Trial II). Remission was assessed by the disappearance of symptoms (overall condition, morning stiffness, functional capacity of the joints and joint pains), and signs (mobility and swelling of the joints). Reduction of joint pains as well as increase of mobility and decrease of swelling of several joints were observed. the clinical signs of reduced inflammation were accompanied biochemically by reduction of serum immunoglobulins and an increase of serum albumin. The need for analgesics was diminished. Severe side-effects and changes in the psoriatic skin involvement were not seen. Oral zinc sulphate seems to be valuable in the treatment of psoriatic arthritis.

Adolescent↗
PubMed1980

Nuclear imaging of pulmonary metastases in thyroid carcinoma.

Pulmonary metastases were diagnosed in 14 of 52 patients with well differentiated thyroid carcinoma by 131I whole body scintigraphy or radiography. Three patients had metastases only demonstrable on scintigraphy, whereas chest radiography was diagnostic in 4 patients with normal scintigraphic findings. Thus, in this type of thyroid carcinoma, neither 131I scintigraphy nor routine chest films alone will reveal all cases of pulmonary metastases.

Adolescent↗
PubMed1978

Bone marrow involvement in mycosis fungoides demonstrated by needle biopsy.

A bone marrow needle biopsy was performed in 19 patients with mycosis fungoides (MF). Two patients, one previously classified as stage 4 and the other with diffuse erythroderma had pathological bone marrow findings. Seventeen patients showed no evidence of bone marrow involvement, 10 of these were in the plaque stage. Bone marrow biopsy can be of value in assessing the stage of the disease.

Adult↗
PubMed1977

Thyroid function in malignant lymphoma.

Thyroid function was studied in 36 patients with various stages of malignant lymphoma. Stage IVB patients exhibited characteristic changes in thyroid biochemistry in the form of lowered triiodothyronine (T3) and elevated free thyroxine (FT4), but normal thyroxine. Moreover, the concentration of thyroxine-binding prealbumin and albumin was lowered, whereas thyroxine-binding globulin was normal. Thyroid-stimulating hormone was slightly elevated but showed a normal increase after administration of thyrotrophin-releasing hormone. Patients with less extensive disease differed only slightly from the controls. The results agree with previous studies of patients suffering from other chronic diseases. The mechanisms underlying the hormonal changes have been only partially elucidated. When investigating patients with disseminated malignant disease for thyroid disease, the above mentioned changes in thyroid biochemistry must be borne in mind. Single analyses of FT4 and T3 may give rise to a false assumption of hyper- or hypothyroid states in patients who are in fact euthyroid.

Adolescent↗
PubMed1977

Transcapillary escape rate of albumin and plasma volume in patients with varying degrees of psoriasis.

Plasma albumin, plasma volume and the transcapillary escape rate of albumin (TERalb), i.e. the fraction of the intravascular mass of albumin that passes to the extravascular space per unit time, were determined using 125I-labelled albumin in 26 patients with varying degrees of psoriasis. For the patients as a group the plasma albumin concentration and the TERalb values were not significantly different from the control group. This contrasts with earlier findings in erythrodermic patients. The plasma volume was significantly reduced whether it was expressed in relation to body weight, height or surface area (P less than 0.001). Thus the intravascular mass of albumin (IVM), determined as the product of the plasma volume and the plasma albumin concentration, was also significantly reduced (P less than 0.001). We found no correlation between the involved skin area and any of the above mentioned parameters. The possible mechanisms in the reduction of the plasma volume and the IVM are discussed. It is suggested that reduced IVM may reflect reduced total albumin mass due to lowered rates of albumin synthesis or increased rates of turnover.

Adolescent↗