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Biomedical subjects

B Lund

Publications and source records attributed to B Lund.

At least 217 records · Page 12Linked to original sources
PubMed1981

Trochanteric and subtrochanteric fractures. One year follow-up of a prospective study of Ender and Mclaughlin osteosynthesis.

The clinical and social status of 110 patients with trochanteric and subtrochanteric fractures was evaluated in a prospective and comparative study 1 year after Ender or McLaughlin osteosynthesis. In both groups the mortality rate during the first year was 21 per cent. There were no significant differences between the two groups concerning pain, hip movement, walking ability of the social status of the patients. Of the 110 patients surviving the first year, 35 per cent were unable to walk, 20 per cent walked with a cane or crutches and 30 per cent had periodic pains in the hip or knee. About 20 per cent of the patients admitted from their own home now lived in nursing homes.

Aged↗
PubMed1981

Tubular proteinuria following jejuno-ileal bypass surgery.

By means of immunonephelometry, determinations of a number of high molecular weight (HMW) and low molecular weight (LMW) proteins in urine and serum were undertaken in 42 consecutive patients, who had been subjected to jejuno-ileal bypass surgery for treatment of massive obesity two to six years before the study. Five patients demonstrated a distinct LWM proteinuira, ie excessive excretion of free-light lamdba and kappa chains of immunoglobulin and beta-2-microglobulin. The creatinine clearance was normal in four of these five patients. This LMW-proteinuria group differed from the remaining 37 patients in several respects. First, they had lost weight more effectively (P less than 0.01); secondly, they exhibited secondary hyperparathyroidism (P less than 0.05), increased levels of alkaline phosphatase and low serum concentrations of bicarbonate (P less than 0.001). It is suggested that LMW proteinuria may be a manifestation of secondary hyperparathyroidism.

Adult↗
PubMed1980

Medical records: a PET computer of your own.

The prospect of computerising medical records might seem a daunting one for many hospitals. However, when the patient services manager at North Tees General Hospital, Brian Lund, and his colleagues, looked closely at the current technology, they found they did not need vast machines nor vast outlay.

Computers↗
PubMed1980

Measurement of bone mineral content (BMC) of the lumbar spine, II. correlation between forearm BMC and lumbar spine BMC.

A comparison between forearm bone mineral content (BMC) and lumbar BMC was made in post-menopausal women. Women without symptoms, women with clinical spinal osteoporosis, and women with prednisone-treated rheumatoid arthritis were studied. A conventional two-dimensional single-photon osteodensitometer was used for measurement of forearm BMC. A new two-dimensional dual-photon osteodensitometer was used for measurement of lumbar BMC. Its radioactive source was 153Gadolinium. The mean lumbar BMC was significantly reduced in women with clinical spinal osteoporosis (P < 0.001). The mean forearm of BMC of those patients was normal. Thus, forearm BMC was a poor indicator of spinal osteopenia. If forearm BMC was used to predict lumbar BMC erroneously high results were obtained in women with clinical spinal osteoporosis, and erroneously low values were obtained in prednisone-treated women with rheumatoid arthritis.

Adult↗
PubMed1980

Serum 1,25-dihydroxycholecalciferol in anephric, haemodialyzed and kidney-transplanted patients. Effect of vitamin D3 supplement.

The serum levels of 25-hydroxycholecalciferol (25-OHD3) and 1,25-dihydroxycholecalciferol[1,25-(OH)2D3] were measured simultaneously in nephrectomized patients on maintenance haemodialysis, in haemodialyzed patients with preserved kidneys who were receiving different vitamin D supplement, and in patients who had undergone renal transplantation. The results indicate that the production of 1,25-(OH)2D3 can be stimulated in patients with minimal residual renal excretory function by increasing the serum levels of 25-OHD3. Successful renal transplantation was followed by a rise in serum 1,25-(OH)2D3 concentrations.

Antigens↗
PubMed1980

Hepatic extraction and renal production of 3,3'-diiodothyronine and 3',5'-diiodothyronine in man.

The sequential deiodination of thyroxine (T4) gives rise to several iodothyronine analogs including 3,3'-diiodothyronine (3,3'-T2) and 3',5'-diiodothyronine (3',5'-T2). In vitro animal studies suggest that the liver and the kidneys are the main sites of both formation and degradation of 3,3'-T2 and 3',5'-T2. To determine the metabolism of 3,3'-T2 and 3',5'-T2 in human liver and kidneys plasma samples were obtained from (a) a brachial artery and a hepatic vein in 20 normal subjects, and from (b) a femoral artery and a renal vein in 11 normal subjects. Further, the hepatic plasma flow (a) and the renal plasma flow (b) were determined. Both plasma 3,3'-T2 and 3',5'-T2 levels were reduced in the hepatic venous blood as compared to arterial values (1.09 +/- 0.40 vs. 1.75 +/- 0.74 ng/dl (P < 0.02)) (mean +/- 1 SD). This resulted in a hepatic extraction of both, 3,3'-T2 and 3',5'-T2, which averaged 8.2 and 5.2 microgram/d, respectively. Plasma 3,3'-T2 as well as 3'5'-T2 levels were higher in the renal vein as compared to arterial values, 1.49 +/- 0.42 vs. 1.39 +/- 0.45 ng/dl (P < 0.05) and 2.35 +/- 0.83 vs. 2.09 +/- 0.81 ng/dl (P < 0.05), respectively. This positive venoarterial difference implies a net production of 3,3'-T2 and 3',5'-T2 in the kidneys of 1.2 and 3.0 microgram/d, respectively. It is concluded that the liver is an important site of 3,3'-T2 and 3',5'-T2 extraction in normal man. In contrast, the renal production of 3,3'-T2 as well as 3'5'-T2 exceeds the degradation and urinary excretion.

Adolescent↗
PubMed1980

Stimulation of 1,25-dihydroxyvitamin D production by parathyroid hormone and hypocalcemia in man.

The serum levels of 1.25-dihydroxycholecalciferol [1,25(OH)2D3] were increased in five patients with primary hyperparathyroidism [60 +/- 13 (SD) pg/ml; normal value, 33 +/- 15 (SD) pg/ml] but fell rapidly after parathyroidectomy to values of 23 +/- 9 (SD) pg/ml. This was accompanied by parallel decreases in the serum concentrations of calcium and immunoreactive parathyroid hormone. Over the following 5--35 days, the serum 1,25(OH)2D3 concentrations increased markedly to levels of 59 +/- 17 (SD) pg/ml, which could most likely be explained by a stimulatory effect of the hypocalcemia per se on the renal production of 1,25(OH)2D3.

Aged↗
PubMed1980

Vitamin D metabolism in hypoparathyroidism.

Only moderately reduced serum 1,25-dihydroxyvitamin D [1,25(OH)2D3] levels were found in 13 hypoparathyroid patients and in 1 pseudohypoparathyroid patient, indicating that factors other than parathyroid hormone are able to mediate the basal production of 1,25(OH)2D3. A significant correlation was found between the levels of circulating 25-hydroxyvitamin D (25OHD) and 1,25(OH)2D, suggesting that a high concentration of 25OHD was able to increase the renal production of 1,25(OH)2D, whereas hypocalcemia and changes in serum phosphate became less important in the present situation. The serum 25OHD and 1,25(OH)2D concentrations were followed during the change of treatment from ergocalciferol to 1 alpha-hydroxycholecalciferol (1 alpha-OHD3). A biological half-life of 3 weeks could be estimated for the plasma 25OHD. The increase in serum 1,25(OH)2D correlated with the dose of 1 alpha-OHD3 given, whereas no correlation was found between the serum calcium level and the 1,25(OH)2D concentration. Unexpected increases and decreases in serum calcium were observed at the same dose of 1 alpha-OHD3 in the same patient and at serum 1,25(OH)2D concentrations within the physiological range.

25-Hydroxyvitamin D 2↗
PubMed1980

Age-dependent variations in serum 1,25-dihydroxyvitamin D in childhood.

Circulating 1,25-dihydroxyvitamin D (1,25-(OH)2D) was measured in 87 children aged 3 months to 15 years, and in 11 adolescents 16-19 years of age. A positive correlation to growth velocity was observed, indicating that the biologically active vitamin D metabolite is an important physiological factor in the regulation of growth and development of the skeleton.

Adolescent↗
PubMed1980

Serum 25-hydroxyvitamin D levels and vitamin D intake in healthy young adults in Britain and Denmark.

The serum 25-hyroxyvitamin D (25-OHD) concentrations of healthy young hospital laboratory workers in Britain and Denmark were compared in relation to assay variation and vitamin D intake. Serum samples from subjects in London and Copenhagen were assayed in both countries. The Danish assay gave higher values than the British assay with a correlation r = 0.88 and a linear regression of British values on Danish values of y = 0.60x + 3.35. Factors which might account for this difference were differences in the extraction procedure and in the range of values covered by the standards used in the two countries. However, the mean serum 25-OHD concentrations of the Danish group were significantly higher than those of the British group when all the samples were assayed in both countries. The mean total daily vitamin D uptake of the Danish group was significantly higher than that of the British group but this difference was almost entirely due to the regular intake of vitamin D tablets by sixteen of the twenty-five Danish subjects. Only one British subject took supplements. The vitamin D content of the food eaten was similar in the two groups. No correlation was found between dietary, as opposed to supplementary, vitamin D intake and serum 25-OHD levels presumably because the exposure of these subjects to ultra-violet light was adequate to compensate for minor differences in intake.

Adult↗
PubMed1979

Myopathy in bone loss of ageing: improvement by treatment with 1 alpha-hydroxycholecalciferol and calcium.

1. Eleven patients with the bone loss of ageing were treated with the vitamin D analogue 1 alpha-hydroxycholecalciferol and calcium for 3--6 months. 2. Muscle biopsies were taken from the vastus lateralis before and after the treatment and the activity of several enzymes was measured. Succinate dehydrogenase and total phosphorylase activities, which are a measure of the oxidative capacity, were low and increased significantly with the treatment. The lactate dehydrogenase activity, which can be taken as a measure of the anaerobic metabolism, was normal and did not change with treatment. The phosphagen stores, ATP and creatine phosphate were low and increased to normal with treatment. 3. Histochemical classification of the fibre composition revealed that the treatment induced an increase in the relative number of fast-twitch a (FTa or type II A) fibres accompanied by a reduction of the fast-twitch b (FTb or type II B) fibres. The cross-sectional area of the FTa fibres also increased with the treatment. 4. The present findings indicate that treatment with the active vitamin D analogue, 1 alpha-hydroxycholecalciferol, and calcium improves the myopathy associated with the bone loss of ageing.

Aged↗
PubMed1979

Impairment of vitamin D and bone metabolism in patients with bypass operation for obesity.

Thirty-four patients were studied 2--6 years after jejunoileal bypass for morbid obesity. The serum concentration of 25-hydroxyvitamin D (25-OHD) were reduced and related to the frequency fo stools and to the weight reduction. Fifteen patients were not able to normalize serum 25-OHD following a long-term regular vitamin D intake. The serum immunoreactive parathyroid hormone concentration (iPTH) and the alkaline phosphatase levels were elevated in this group, indicating a secondary hyperparathyroidism. The mean bone mineral content of the forearm was reduced 3--6 years after the operation, most severely in those with elevated serum iPTH. The desired weight reduction by jejunoileal shunt was obtained at the expense of a severely disturbed vitamin D metabolism. We suggest, that all patients with an intestinal bypass for obesity should receive regular vitamin D supplement, and serum 25-OHD should be measured in order to monitor the effect of therapy.

Adult↗
PubMed1979

Fractional intestinal calcium absorption in epileptics on anticonvulsant therapy. Short-term effect of 1,25-dihydroxycholecalciferol and 25-hydroxycholecalciferol.

Fractional intestinal 47Ca calcium absorption (alpha) in 12 epileptic outpatients receiving chronic high-dose anticonvulsant therapy was reduced (p less than 0.05) compared to 12 matched normal controls. Six of the epileptics were treated orally with 0.5 microgram of 1,25-dihydroxycholecalciferol (1,25-DHCC) per day and six with 10 microgram of 25-hydroxycholecalciferol (25-HCC) per day for 10 days. The alpha was determined before and after treatment and compared with the effect of 0.5 microgram of 1,25-DHCC per day given for 10 days to 6 controls. An increase of the same order in alpha was found in all groups (p less than 0.05). No changes were observed in the serum levels of calcium, phosphorus, alkaline phosphatase or iPTH during treatment. Urinary calcium excretion was low in the epileptic patients and rose during treatment. The investigation demonstrates that the sensitivity of the intestine to 1,25-DHCC is normal in epileptic patients on anticonvulsant therapy and that 1,25-DHCC and 25-HCC in the given doses had an equal effect on the reduced intestinal calcium absorption.

Administration, Oral↗
PubMed1979

Reduced vibratory perception and corneal sensitivity and metabolic disturbances following intestinal bypass surgery.

Decreased corneal sensitivity and vibratory perception suggesting a diagnosis of polyneuropathy were demonstrated in some of 26 patients who had undergone intestinal bypass surgery. Psychological tests revealed signs of disturbance of the autonomic nervous system. A deficiency of 25-hydroxyvitamin D was demonstrated, clearly related to the frequency of stools and to the weight loss. This deficiency might play a role in the pathogenesis of the polyneuropathy.

Adolescent↗