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Biomedical subjects

B Lilja

Publications and source records attributed to B Lilja.

At least 73 records · Page 4Linked to original sources
PubMed1989

Dry eyes or mouth--an epidemiological study in Swedish adults, with special reference to primary Sjögren's syndrome.

The prevalence of dry eyes or dry mouth, and of primary Sjögren's syndrome (primary SS) according to the Copenhagen criteria were established in 705 randomly selected subjects, aged 52-72 years who answered a simple questionnaire, and of whom 247 (35%) reported symptoms. A subgroup with symptoms (n = 77) and a matched asymptomatic control group (n = 32) were examined with the Schimer-1 test (S1t), tear film break-up time (BUT), van Bijsterveld score (vB), unstimulated whole sialometry (Sialo) and, in about 40% of them labial salivary gland (LSG) biopsy and salivary gland scintigraphy. Apart from four cases of keratoconjunctivitis sicca (KCS) among controls, cases of KCS (15), xerostomia (12), autoimmune sialoadenitis (6) and primary SS (6) were exclusively confined to the symtomatic group. The calculated frequencies (with 95% confidence intervals) for the whole population were 14.9 (7.3-22.6)% for KCS, 5.5(3.0-7.9)% for xerostomia and 2.7 (1.0-4.5)% for autoimmune sialoadenitis and primary SS. The serum levels of ANA and RF were similar in the two groups, though those of anti-SS-B/La antibodies were higher in the group with symptoms (P less than 0.01).

Aged↗
PubMed1989

Platelet sodium and potassium ATPase [corrected] activity and noradrenaline efflux rate in relation to autonomic and peripheral nerve function in insulin-dependent diabetic patients.

Low sodium and potassium adenosine triphosphatase (ATPase) activity has been proposed as a mechanism behind diabetic neuropathy. In this study the platelet ATPase activity and platelet noradrenaline efflux rate were determined in 47 insulin-dependent diabetes mellitus (IDDM) patients and 20 controls. Ulnar motor conduction velocities, tested in a subgroup, were lower in patients than in controls (52.7 +/- 1.3 m s-1 vs. 61.3 +/- 1.4 m s-1; P less than 0.001). Platelet ATPase activity tended to be increased in the patients compared with the controls (29.9 +/- 1.0 x 10(-3) min-1 vs. 26.9 +/- 1.1 x 10(-3) min-1; NS). In ulnar nerve function tested subjects, ATPase activity was higher in patients than in controls (31.2 +/- 1.7 x 10(-3) min-3 vs. 25.9 +/- 1.3 x 10(-3) min-1; P less than 0.01). The platelet noradrenaline efflux rate tended to be higher in patients with lower brake indices, a sign of autonomic neuropathy, than in controls (29.0 +/- 3.0 x 10(-3) min-1 vs. 21.2 +/- 0.9 x 10(-3) min-1; P less than 0.05). The platelet ATPase activity was not decreased in IDDM patients, however, a connection between diabetic autonomic neuropathy and platelet transmittor leakage was indicated.

Adult↗
PubMed1989

Effect of xamoterol on exercise capacity and left ventricular function in angina pectoris and in dilated cardiomyopathy.

The present study evaluates the effect of the beta 1 partial agonist xamoterol in patients with coronary artery disease compared to the effect in patients with dilated cardiomyopathy. Nineteen patients with angina pectoris and nine patients with dilated cardiomyopathy received xamoterol 200 mg b.i.d. for 4 weeks in a placebo-controlled double-blind study. The effect was evaluated with a standardized exercise test and radionuclide angiocardiography with determination of global and regional ejection fraction. At rest xamoterol caused no significant changes among the angina patients while global and regional ejection fraction increased among the cardiomyopathy patients. During exercise, when the drug exerts a beta 1-antagonist effect, xamoterol increased the exercise performance among the angina pectoris patients. Fourteen out of 19 patients with angina pectoris were unable to increase their ejection fraction from rest to work due to coronary ischaemia. These 14 patients improved their global ejection fraction during work after xamoterol treatment.

Adrenergic beta-Agonists↗
PubMed1989

Impaired responses of plasma catecholamines to exercise in diabetic patients with abnormal heart rate reactions to tilt.

The plasma catecholamine response to a standardized bicycle exercise test was evaluated in 24 insulin-dependent diabetic (IDDM) patients in whom the heart rate reactions to deep breathing (E/I ratio) and to tilt, the immediate acceleration and the transient deceleration (acceleration and brake indices), had been assessed as tests of autonomic neuropathy. Patients with an abnormal acceleration index (n = 8) showed, compared with non-diabetic (n = 18) controls who had participated in previous studies, an impaired increment in noradrenaline during exercise (80% of maximal working capacity) (MWC) (12.38 +/- 1.46 nmol l-1 vs. 18.74 +/- 1.45 nmol l-1; P less than 0.01) and adrenaline (50% of MWC: 0.25 +/- 0.04 nmol l-1 vs. 0.54 +/- 0.08 nmol l-1; P less than 0.05). Similarly, patients with an isolated abnormal brake index (n = 6), i.e. with a normal acceleration index and a normal E/I ratio, showed compared with controls an impaired increment in noradrenaline (9.53 +/- 1.66 nmol l-1 vs. 18.74 +/- 1.45 nmol l-1; P less than 0.01) and adrenaline (1.41 +/- 0.22 nmol l-1 vs. 2.92 +/- 0.51 nmol l-1; P less than 0.05) during 80% of MWC. IDDM patients with abnormal heart rate reactions to tilt, an abnormal acceleration index or an abnormal brake index show impaired catecholamine responses to exercise, which can be demonstrated also in patients without signs of parasympathetic neuropathy.

Acceleration↗
PubMed1988

The effect of oral diltiazem on left ventricular performance in postinfarction patients.

The purpose of the present study was to evaluate the effect of diltiazem on the left ventricular function in postinfarction patients. Twelve patients without cardiac decompensation at rest began diltiazem therapy beginning 3 months after an acute myocardial Q-wave infarction. Oral diltiazem was administered on the first day in a single dose (120 mg) and the following 2 weeks in a 60 mg three times a day (tid) regimen. The therapeutic effect was studied by isotope angiocardiography at rest using equilibrium measurements with technetium-99m. Acute as well as continuous treatment improved left ventricular function in terms of increased synergy of the contraction (decreased phase deviation from a median of 20.0 degrees to median of 12.4 degrees and 13.0 degrees, respectively, p less than 0.01) and increased ejection fraction from a median of 46% to a median of 50% and 51%, respectively, p less than 0.05. It is suggested that the improvement of left ventricular function may be due in part to decreased pressure rate product. This improved left ventricular function during diltiazem treatment may explain the improved prognosis induced by diltiazem in postinfarction patients.

Administration, Oral↗
PubMed1988

Repeated quantitative bone scintigraphy in patients with prostatic carcinoma treated with orchiectomy.

Bone scintigraphy was performed in 16 men with newly diagnosed prostatic carcinoma before orchiectomy as well as 2 weeks and 2 months after operation. The uptake in the lower thoracic and lumbar vertebrae was registered up to 240 min after injection of 99mTc-MDP and was then calculated for each patient and vertebra. The relative standard deviation in measured uptake due to measuring technique was estimated to be +/- 7%. In eight patients, who had normal bone scintigraphies before orchiectomy, there were no changes in the uptake values after operation. The remaining eight patients had widespread metastatic involvement prior to treatment. Six of these patients showed a so called "flare phenomenon" in the abnormal vertebrae which means an initial increase in uptake after operation followed by a decreased uptake in response to therapy. One patient had a continuously increased uptake in all the abnormal vertebrae which correlated well with the clinical progression of the disease, while in another patient both reactions were seen. Thus, repeated quantitative bone scintigraphies using 99mTc-MDP can be made in a reproducible way and can be a useful tool to follow a patient's response to treatment.

Aged↗
PubMed1988

Ventricular arrhythmias and left ventricular function: one-year follow-up after myocardial infarction.

One hundred and one consecutive post-myocardial infarction (MI) patients were investigated with 24-h long-term ECG registration (LTER), exercise test and radionuclide angiocardiography (RNA) within one month of the MI and after six and 12 months. Patients with low left ventricular ejection fraction (LVEF) or a high value in a quantified phase analysis (Phase SD) were found to have frequent ventricular arrhythmia and high Lown class. Significant correlations between LVEF or phase SD and the number of ventricular arrhythmias or Lown class were found (P less than 0.05). Frequent ventricular arrhythmias and high Lown class were also found in patients with inverse left ventricular wall movement at RNA. Prolonged QTc was found in patients with frequent ventricular arrhythmias. These connections were found at all three investigations during the follow-up year. A significant correlation was not observed between ventricular arrhythmias and exercise capacity, NYHA grouping, ST depression in an exercise test or symptoms of angina pectoris. More than 300 ventricular premature complexes (VPC) per 24 h was found to predict death during the follow-up year as was LVEF less than 30%; complex arrhythmia (i.e., the patient being in Lown classes 3-5) being the only factor to predict repeat-MI during the follow-up year. It is concluded, that ventricular arrhythmias in the post-MI patient reflect the left ventricular performance. Both LVEF and arrhythmias contribute univariately to the risk of death during the first year after an MI. Whether they both carry independent prognostic information for death must be studied in future larger trials.

Adult↗
PubMed1988

The effect of atenolol on the left ventricular performance in patients with angina pectoris measured with isotope technique.

Working capacity, left ventricular ejection fraction (EF), stroke volume and the phase of the left ventricular contraction were tested before and after 3 weeks of atenolol treatment in 14 patients with angina pectoris and coronary insufficiency diagnosed by thallium tomography. Eight patients (group A) increased their EF during exercise and six patients (group B) showed a decrease in EF when tested with placebo. When treated with atenolol the changes in EF during exercise were reversed in the two groups. Group B increased and group A decreased their EF. Atenolol caused an increase in working capacity in group B, but not in group A. In both groups atenolol caused an increased stroke volume and a decreased phase deviation at rest, while no significant volume changes or phase changes occurred during exercise. These results indicate that atenolol treatment had the most marked effect in patients with the most pronounced disease.

Adult↗
PubMed1988

Measurement of global and regional left ventricular performance with isotope technique in coronary heart disease.

In order to evaluate the left ventricular function in coronary artery disease, radionuclide measurements of global and regional ejection fraction (EF), regional wall motion and phase analyses of the left ventricular contraction were performed by equilibrium technique. One group of patients with angina pectoris and one group with myocardial infarction were compared with a control group. All the above-mentioned parameters significantly separated the infarction group from the reference group both at rest and during work, while the group of patients with angina pectoris showed disturbances mainly during work, such as impaired ability to increase global and regional ejection fraction and regional wall motion. Adding regional analysis and phase analysis to the global EF determination increases the possibility of studying the left ventricular function. However, this addition has a limited value in detecting impaired left ventricular function compared to the determination of just global EF in patients with angina pectoris and in patients with myocardial infarction.

Adult↗
PubMed1988

Longstanding groin pain in athletes. A multidisciplinary approach.

In 21 male athletes (age 20 to 40 years) with longstanding unexplained groin pain, a multidisciplinary investigation was performed in order to reveal the underlying cause. These examinations included general surgery for detection of inguinal hernia and neuralgia, orthopaedic surgery for detection of adductor tenoperiostitis and symphysitis, urology for detection of prostatitis, radiology for performing herniography and plain film of the pelvic bones, nuclear medicine for isotope studies of the pubic bone and symphysis. In 19 patients there was a positive diagnosis for 2 or more of the diseases (10 patients had 2 diseases, 6 patients had 3 diseases, 3 patients had 4 diseases). Two patients had only signs of symphysitis. Our results show the complexity of longstanding groin pain in athletes. It also explains why therapy for one specific disease entity may fail. We conclude that this clinical setting demands the recruitment of a team with experience of different aspects of groin pain.

Adult↗
PubMed1988

Absent elevations in growth hormone, factor VIII related antigen, and plasminogen activator activity during exercise in diabetic patients resistant to retinopathy.

In cross-sectional studies elevations in growth hormone (GH), factor VIII related antigen (VIIIR:Ag), and plasminogen activator activity (PAA) have been connected with diabetic retinopathy. To evaluate the importance of these factors for the development of retinopathy, we have carried out a prospective study. In a primary study GH, VIIIR:Ag, and PAA were evaluated during a 25 min exercise test in 22 insulin dependent diabetes mellitus (IDDM) patients. After 5-7 years, the patients were re-evaluated and the presence of retinopathy in the follow-up study was correlated to the findings in the primary study. Patients with retinopathy in the primary or the second study (n = 14) showed a significant increase in GH (p less than 0.05) during the first 5 min of exercise compared with patients without retinopathy. Moreover, the 14 retinopathy patients showed further significant elevations in GH (p less than 0.001), VIIIR:Ag (p less than 0.01) and PAA (p less than 0.001) during the remaining 20 min of exercise. In contrast, patients without retinopathy (n = 8) in the follow-up study, did not show significant elevations in GH, VIIIR:Ag, and PAA during exercise. A lack of rise in GH, VIIIR:Ag, and PAA during exercise seems to indicate a resistance to retinopathy in IDDM patients.

Adult↗
PubMed1988

Radionuclide angiocardiography in post-myocardial infarction patients. Importance of the phase image of the left ventricle.

One hundred and one representative post-myocardial infarction (MI) patients were investigated with radionuclide angiocardiography (RNA) and exercise test within 1 month of the MI and after 6 and 12 months. From the RNA were calculated the left ventricular ejection fraction (LVEF) and a quantified phase image, the phase standard deviation (phase-SD), representing the timing of the left ventricular contraction. The mean phase-SD was significantly higher among these patients (18 degrees, 19 degrees and 18 degrees, respectively, at the three investigations) compared to phase-SD in normals (6 degrees), indicating an impaired timing of the left ventricular (LV) contraction. At all three investigations a significant correlation was found between the phase-SD and the LVEF (r = -0.58, r = -0.74 and r = -0.75, respectively) and the corrected QT interval (r = 0.27, r = 0.44 and r = 0.39, respectively). Maximal serum ASAT in patients with their first MI correlated significantly to phase-SD. Low exercise capacity or unfavourable NYHA classification was associated with high phase-SD. Phase-SD higher than mean was also associated with significantly increased mortality during the follow-up year (p = 0.0057). In conclusion, phase-SD, reflecting the timing of the LV contraction wave, is easily accessible and clinically relevant. It merits further investigation as a prognostic factor after an MI.

Adult↗
PubMed1987

Autonomic and peripheral nerve function in early diabetic neuropathy. Possible influence of a novel aldose reductase inhibitor on autonomic function.

Autonomic and peripheral nerve functions as well as the possible short-term effect of a novel aldose reductase inhibitor (ARI) on neuropathy were evaluated in 30 male type I diabetics (age 25-44 years, mean 34; duration of diabetes 10-20 years, mean 34) with neurographic signs of peripheral neuropathy (PN). Autonomic neuropathy (AN) was established by the heart rate reactions to deep breathing (E/I ratio = vagal function) and to tilt (acceleration index = sympathetic and vagal functions; the brake index = vagal function). Twenty-nine patients, 13 with AN, completed the study. Among neurographic variables, only sural nerve function tests correlated with autonomic functions. Patients with AN showed significantly lower mean sensory action potential amplitudes (SAPA) sural, indicating axonal losses, than patients without AN (3.58 +/- 0.79 microV v. 7.34 +/- 1.12 microV; p less than 0.01). PN as measured by neurography did not improve during ARI treatment. On the other hand, vagal function (brake indices) improved (p less than 0.05) during ARI in AN patients.

Adult↗
PubMed1987

Autonomic neuropathy in type I diabetes: influence of duration and other diabetic complications.

To evaluate the influence of duration on the development of autonomic neuropathy (AN) a group of type I diabetic patients (n = 58) who had been diagnosed between the ages of 15 and 25 years was investigated. The duration of diabetes varied from 2 months to 30 years (mean 13 years). AN tests included a deep breathing test (E/I ratio) and an orthostatic test on tilt table (acceleration and brake indices) and the results were corrected for age. A clear correlation between AN test and duration of diabetes was shown only for the E/I ratio (r = -0.44, p less than 0.001). On the other hand, deteriorations in the brake index were unrelated to the duration of diabetes and occurred early; 35% of the patients with a duration of 10 years or less showed an abnormal brake index. Autonomic test deviations were related to other diabetic complications. The E/I ratio and the acceleration index were especially low in patients with retinopathy as well as in patients with symptoms of AN if combined with peripheral neuropathy (PN). The brake index was low in patients with symptoms of AN independent of PN.

Adolescent↗
PubMed1987

Radionuclide left ventricular volume determination. Influence of scattered radiation and surrounding activity.

Radionuclide measurements of left ventricular volumes, ejection fractions and stroke volumes were performed by an equilibrium technique in nine patients using left anterior oblique projection and individual depth correction. Phantom studies were made in order to evaluate attenuation and scattering of the radiation. It was found that a simple depth correction factor, k(d) = e mu d, can be used under certain conditions. However, the determination of left ventricular volume by radionuclide techniques is not a truly absolute method. The depth correction factor to be used is dependent on the condition of measuring and evaluation, for instance how the region of interest for the left ventricle is selected. Therefore, this method should be carefully standardized, evaluated and compared to other techniques. Stroke volume measured by radionuclide and dye-dilution technique showed a correlation coefficient of 0.76 (nine patients) at rest and 0.77 (seven patients) at work. This method can be easily performed during routine ejection fraction determination and can thus be useful in clinical studies.

Adult↗
PubMed1987

Gastric emptying in smokers.

We investigated the gastric emptying of a small solid meal in 21 healthy middle-aged men. Nine heavy smokers and 12 non-smokers were studied with a scintigraphic technique, using 99Tc-tin colloid as a tracer. All subjects had been instructed to abstain from smoking for at least 10 h before and during the examination. Smokers had on an average a shorter gastric emptying half-time (24.2 +/- 8.5 min) than non-smokers (40.6 +/- 14.1 min) (p less than 0.01). We conclude that habitual smoking has not only acute effects on gastric emptying but also a more long-standing influence.

Carboxyhemoglobin↗
PubMed1987

The effect of external pressure on intramuscular blood flow at rest and after running.

Local blood flow in the thigh was measured with 133Xe clearance technique in eight male distance runners after compression with a foam rubber compress and a standard elastic bandage. Two degrees of compression were tested, and an initial experiment with rested subjects was followed by a similar experiment immediately after running. Maximum compression exerted a cutaneous pressure of 85 (+/- 8) mm Hg and caused an immediate cessation of intra-muscular blood flow in the compressed area. Moderate compression gave a cutaneous pressure of 40 (+/- 5) mm Hg and resulted in a reduction of blood flow by approximately 50%. During compression, there were no significant differences in the blood flow of rested subjects compared to subjects immediately after running. In acute soft tissue injuries, a maximum compression bandage should effectively reduce or eliminate the formation of an intra-muscular hematoma, and an additive effect on blood flow of ice should not be expected.

Adolescent↗