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Biomedical subjects

B Lantz

Publications and source records attributed to B Lantz.

At least 19 recordsLinked to original sources
PubMed1994

Biocompatibility of hemodialysis membranes: a study in healthy subjects.

The effect of blood-membrane interaction on several biocompatibility parameters has been investigated. Four groups of healthy subjects underwent sham hemodialysis, i.e. the establishment of blood-dialysis membrane contact, but without circulating dialysate, using cellulose-based membranes (regenerated cellulose and cellulose acetate) or synthetic membranes (polysulfone and polyacrilonitrile). Contact between blood and cellulose-based membranes resulted in pronounced complement activation and leukopenia whereas contact between blood and synthetic membranes induced weak complement reaction. The release of granulocytic elastase comparable to that obtained during clinical dialysis seemed to correlate directly with the types of membrane used. The gradual increase in the level of plasma elastase during blood-membrane contact, as opposed to the transient nature of the increase in the levels of complement, suggests that different mechanisms are responsible for these reactions. Nutritional implications of dialysis membrane bioincompatibility are discussed in the light of recently published metabolic data obtained in these subjects.

Acrylic Resins↗
PubMed1994

Short-term niflumic-acid-induced acute renal failure in children.

Several reports emphasize the adverse effects of non-steroidal anti-inflammatory drugs (NSAIDs) on renal function. We have observed over the last 10 years seven cases of acute renal failure (ARF) due to immune interstitial nephritis in children. A recommended oral or rectal dose of niflumic acid was prescribed for ear-nose-throat disorders. Length of exposure was 1-5 days. Clinical symptoms (oedema, oliguria or anuria) appeared between 3 and 6 days. Three patients had previously received the drug. Hypersensitivity signs (fever, skin rash, eosinophilia, and/or increased IgE) were present in all cases, leukocyturia in five cases, and haematuria in six cases. Renal biopsy showed interstitial lesions with lymphocyte, eosinophil, and plasma cell infiltrates without tubular cell necrosis. Glomeruli were normal on light-microscopy, except in one patient. Electron-microscopy showed extensive podocyte fusion in two patients, who had clinical and laboratory evidence of nephrotic syndrome (NS). ARF rapidly disappeared after NSAID withdrawal, except in two patients whose renal failure was irreversible despite methylprednisolone bolus. ARF is very rare in children treated with niflumic acid. When ARF occurs, different pathophysiological mechanisms are involved but the most common is immunological.

Acute Kidney Injury↗
PubMed1993

beta 2-Microglobulin and granulocyte elastase.

Plasma beta 2-M was measured by radioimmunoassay in samples obtained before and after dialysis with seven different dialysers, tested according to the protocol of the International Cooperative Biocompatibility Study (ICBS). Plasma beta 2-M was corrected for contraction of its distribution volume, which was assumed to be equal to the extracellular fluid volume. The uncorrected plasma beta 2-M concentration increased with all conventional dialysers, including the G10-3N, (cuprammonium cellulose plate), G120 M (cuprammonium cellulose hollow fibre), CD 4000 (cellulose acetate) and T 150 (polymethylmethacrylate). However, no significant differences were found between the predialysis and the corrected postdialysis plasma beta 2-M concentrations with these conventional dialysers, and thus no evidence of net generation or release of beta 2-M was found in this study. With high-permeability membranes, the corrected postdialysis beta 2-M values were decreased by 27.1% with the Duo-Flux Artificial Kidney, 53.5% with F 60, and 34.6% with Filtral, indicating that dialysers with these membranes eliminate plasma beta 2-M to a certain extent. The complex of granulocyte elastase with alpha 1-antiproteinase in plasma was also measured in samples from the arterial blood line collected before, and after 30 and 120 min of dialysis with each of the seven dialysers in this study. All dialysers elicited an increase in the mean plasma elastase concentrations which was more than twice as high with cuprammonium cellulose plate than with all of the others. The change of elastase at 120 min of dialysis varied considerably with each dialyser and was statistically significant with all except CD 4000, F 60, and Filtral.(ABSTRACT TRUNCATED AT 250 WORDS)

Cellulose↗
PubMed1993

Non-steady-state kinetics of low density lipoproteins in man: studies after plasma exchange in healthy subjects and patients with familial hypercholesterolaemia.

Five patients with heterozygous familial hypercholesterolaemia (FH), one patient with non-familial hypercholesterolaemia, and four healthy normals were treated with plasma exchange (PE). In order to achieve a non-steady-state situation with low plasma cholesterol levels, PE was performed twice in each subject at an interval of 1-3 days. At each time, 1500 ml of plasma were removed and replaced with colloids and albumin. Lipoprotein analyses were performed daily in all subjects for a period of 14 days following PE. Kinetic calculation of LDL cholesterol data using a two-compartment open model was performed, and rate constants, synthetic rate and apparent clearance of LDL were determined. A lower clearance and a tendency towards a higher synthesis of LDL were observed in the FH patients. In four of the subjects, LDL kinetics was also studied with the conventional 125I-LDL turnover technique. The synthetic rates of LDL were compared using data derived from PE and 125I-LDL kinetics. The two techniques showed a good correlation (r = +0.93) although synthetic rates in general were higher when calculated from the 125I-LDL procedure (3.98 vs. 2.64 mmol d-1 for LDL cholesterol synthesis). The results indicate that non-steady-state kinetics of LDL, as measured using the PE technique, is a useful method for analysis of LDL metabolism.

Adult↗
PubMed1990

Observations on biochemical and haematological parameters in healthy people above 80 years of age.

Ninety-five apparently healthy people, aged 80 years or above, living in the Stockholm County Council of Sweden, participated in a pilot study in 1984. Reference values were obtained for routine haematological and biochemical analyses. Deviations from expected levels were confined to thyroid-stimulating hormone (TSH), vitamin B12 and calcium. It is noteworthy that a low-risk cholesterol level characterized this elderly population. It is suggested that in order to evaluate the influence of age, a dynamic aspect should be added using functional tests of various organs.

Aged↗
PubMed1990

Meniscal cysts.

Meniscal cysts are cysts that occur as a direct extension, or within the substance of the meniscus. The incidence varies in reports from 1% to 20% and are much more common laterally. They usually present as joint-line pain, swelling, or both in young adult men, and are often associated with meniscal tears. The exact etiology of meniscal cysts is unknown. A myxoid degenerative process is identified histologically. There is often a history of precedent trauma. Diagnosis is often suspected clinically and can be confirmed by arthrogram, CT, or MRI when necessary. Conservative treatment in the patient with few symptoms is recommended. Should the cyst become significantly symptomatic, it is necessary to treat the meniscal pathology to prevent a cyst recurrence. At the present time it is our recommendation that this be done by arthroscopically resecting the meniscus back to normal meniscus and either aspirating and injecting the cyst with steroid or local cyst excision if the aspiration and injection fails. If no meniscal tear is documented at arthroscopy, exploration and excision of the cyst are recommended.

Arthrography↗
PubMed1989

Short tertatolol treatment does not impair the hormone and metabolic responses to exercise and hypoglycemia in diabetics.

Beta-blockers can precipitate hypoglycemia and mask its warning signs. Ten male insulin-dependent, otherwise healthy diabetic patients underwent two submaximal exercise tests and two insulin-induced hypoglycemic events (0.2 u/Kg short-acting insulin IV) after six days administration of placebo followed by tertatolol, a non selective beta-blocker (5 mg once daily). Tertatolol modified neither the exercise-induced changes in blood glucose, lactate and plasma unesterified fatty acid levels, nor those of counter regulatory hormones (glucagon, growth hormone, cortisol), while blood pressure, heart rate and plasma renin activity were significantly reduced, proving that tertatolol had actually been ingested, and was active. During the insulin-induced hypoglycemia, similarly tertatolol did not modify the course of the plasma fuels and hormones. Particularly, hypoglycemia was neither deeper nor more prolonged in the presence than in the absence of tertatolol. Warning symptoms were not affected except for palpitations which were not perceived. These results suggest that tertatolol did not precipitate hypoglycemia following exercise, and did not aggravate insulin-induced hypoglycemia in short term administration, and in otherwise healthy diabetic patients.

Adrenergic beta-Antagonists↗
PubMed1989

Lipid lowering in severe familial hypercholesterolaemia: efficacy and safety of a new regenerating system for selective apheresis of apolipoprotein B-containing lipoproteins.

Preliminary experience of the efficacy and safety of a new regenerating system for selective extracorporeal removal of apolipoprotein B-containing lipoproteins is described. Four patients with familial hyperlipoproteinaemia were studied on 10 occasions. A system of two, parallel, dextran sulphate cellulose columns was used, and plasma was processed continuously by passage through one of the columns while the other was being regenerated. With this procedure, reductions of very low density and low density lipoprotein cholesterol levels by 73 and 43%, respectively, could be achieved after treatment for 2.5-3 h (1000-3200 ml of plasma volume). No clinically relevant changes in the concentrations of other plasma proteins, including high density lipoproteins, were observed, and the treatment was well tolerated. We conclude that continuous selective apolipoprotein B apheresis is a safe and efficient lipid-lowering procedure which may be used both for metabolic investigations and for studies on possible regression of atherosclerosis.

Apolipoproteins B↗
PubMed1988

Bradyarrhythmia profile and associated diseases in 1,265 patients with cardiac pacing.

Twelve hundred and sixty-five patients with implanted cardiac pacemakers were reviewed for known associated conditions and for the resulting bradycardia patterns. The group bradyarrhythmia profile was AV block in 75%, sick sinus syndrome (SSS) in 21% and combined arrhythmias in 4%. Thyroid diseases and acquired valvular disease were frequently associated with AV block especially of the Wenckebach type. Sick sinus syndrome occurred significantly more frequently in women (28%) than in men (26%). Isolated bradyarrhythmias (i.e., with no associated disease) were 22% of the entire group with a 26% incidence of SSS and with a significant association with previous gastric resection, pernicious anemia, and malabsorption compared to the groups with other associated diseases. Degenerative cardiac lesions caused by malabsorption and undiagnosed hypothyroidism in elderly women may contribute to the group of apparently isolated bradyarrhythmias.

Aged↗
PubMed1988

Coccidioidomycosis of the knee with a 26-year follow-up evaluation. A case report.

A case of coccidioidomycosis of the knee caused by the fungus Coccidioides immitis demonstrates the chronicity of this disease as well as the disability incurred. The patient was completely asymptomatic for 11 years after initial treatment but developed progressive joint destruction, disabling pain, and loss of function. The nature of fungal infections in bone and joint necessitates long-term follow-up evaluation, even with adequate surgical debridement and medical therapy.

Arthritis, Infectious↗
PubMed1987

Granulocyte elastase-alpha 1-antiproteinase complex in cystic fibrosis: sensitive plasma assay for monitoring pulmonary infections.

Elastase in plasma was determined as a complex of granulocyte elastase and alpha 1-antiproteinase (GEC) by an enzyme-linked immunosorbent assay in 67 patients with cystic fibrosis. The patients were observed for 1 years, when clinically infected and noninfected. Although noninfected patients had GEC levels within the normal range, the mean value was significantly higher than the mean values in patients in an optimal noninfectious state (P less than 0.01) and in healthy controls (P less than 0.001). Clinical signs of (in most cases) low-grade infection were paralleled by significant increases in GEC levels (P less than 0.001). There was no correlation with different types of bacteria or age of patients. No cross reaction to Pseudomonas elastase could be found in vitro or in vivo. Significant decreases of GEC values were seen after intravenously administered antimicrobial therapy (P less than 0.001), and although the white blood cell count and erythrocyte sedimentation rate were rarely increased above the normal range, they decreased congruently (P less than 0.001), and lung function improved (P less than 0.001). The sensitivity of GEC was significantly higher than that for erythrocyte sedimentation rate (P less than 0.01) and white blood cell count (P less than 0.05). Determination of GEC values seems to be a simple and sensitive measurement for monitoring treatment in cystic fibrosis, especially of low-grade infections in patients with normal standard blood tests.

Adolescent↗
PubMed1987

Plasma exchange in a patient with heterozygous familial hypercholesterolaemia resistant to drug therapy.

A 40-year-old male with heterozygous familial hypercholesterolaemia was resistant to combined drug treatment with cholestyramine and nicotinic acid in adequate doses. He had angina pectoris and evidence of three vessel disease in the coronary angiogram. Repeated plasma exchange at intervals of 1-3 weeks simultaneously with combined drug treatment decreased the plasma cholesterol levels by nearly 40%. There were also signs of regression of xanthomata and some improvement of his angina pectoris. No progression of atherosclerosis was seen angiographically after two years treatment. Plasma exchange may be a therapeutic alternative in drug-resistant familial hypercholesterolaemia.

Adult↗
PubMed1986

Renal hemodynamic effects of tertatolol in essential hypertension.

Tertatolol, a new beta-blocker, and propranolol, considered a reference beta-blocker, were given orally (5 and 160 mg slow release, respectively) for 15 days to two groups of patients with essential hypertension in order to compare their effects on renal hemodynamics. Systolic and diastolic blood pressure, heart rate, and erect plasma renin activity fell significantly in both groups while prostaglandin E2 urinary excretion was unchanged. Tertatolol administration produced increases in glomerular filtration rate, as shown by inulin clearance (+8.9%; p = 0.038) and renal plasma flow, as shown by paraaminohippurate clearance (+13.0%; p = 0.007). In contrast, propranolol administration resulted in a slight decrease in glomerular filtration rate (-2.8%; not significant) and a fall in renal plasma flow (-13.4%; p less than 0.001). Comparison between both treatments showed that glomerular filtration rate and renal plasma flow were higher in the patients treated with tertatolol than in those treated with propranolol whereas filtration fraction was lower, which suggests that tertatolol causes a vasodilation of the glomerular afferent arteriole. These results demonstrate that in contrast to propranolol (160 mg), and despite both drugs exhibiting a comparable antihypertensive activity, tertatolol (5 mg) does not alter but even improves renal perfusion in hypertensive patients.

Adrenergic beta-Antagonists↗
PubMed1986

Effects of tertatolol in hypertensive patients with chronic renal failure.

Chronic renal failure (CRF) is often associated with hypertension, as a cause or a consequence. We studied the changes in blood pressure (BP), heart rate (HR), renal function (as measured by creatinine clearance), and plasma renin activity (PRA) in 19 hypertensive patients with CRF before, during and after oral administration once a day for at least 30 days of 5 mg tertatolol, a new beta-blocker. All patients were free of any antihypertensive medication for at least 1 month before administration of tertatolol. The dose of tertatolol given in this study was the same as that commonly used in patients with normal renal function. From day 0 to day 30 of tertatolol, measurements in the supine position were as follows: systolic BP (SBP) decreased from 168.4 +/- 4.6 to 145.3 +/- 4.3 mm Hg (p less than 0.01); diastolic BP (DBP) decreased from 106.1 +/- 2.4 to 87.1 +/- 2.0 mm Hg (p less than 0.01); HR decreased from 77.9 +/- 1.6 to 63.2 +/- 1.7 b.p.m. (p less than 0.01); PRA decreased from 1.816 +/- 0.521 to 1.052 +/- 0.323 ng/ml/h (p less than 0.01). Creatinine clearance remained stable: 37.1 +/- 4.1 versus 37.1 +/- 4.7 ml/min/1.73 m2 (not significant). Similar results (for SBP, DBP, HR and PRA) were obtained in the erect position. It is concluded that tertatolol in hypertensive patients with CRF: significantly lowers BP and HR without excessive bradycardia, significantly lowers PRA, the most important decrease being observed for the highest initial PRA, does not alter renal function, and has a good clinical acceptability.

Adrenergic beta-Antagonists↗