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Biomedical subjects

B Lundh

Publications and source records attributed to B Lundh.

At least 55 records · Page 3Linked to original sources
PubMed1979

Hematological side effects from antihypertensive drugs.

To sum up, some hematological side effects are seen after antihypertensive drugs. They are, however, few, usually not severe and furthermore reversible. And so, from the viewpoint of the hematologist, there are no contraindications against antihypertensive treatment. The prevalence of side effects on blood and blood-forming organs from antihypertensive drugs is low. Of certain interest are 1) the tendency of modern diuretics (thiazides) to cause a moderate and reversible thrombocytopenia and 2) the positive antiglobulin reaction (Coomb's test) sometimes seen after alpha-methyldopa therapy and in a few cases causing autoimmune hemolytic anemia. Even though case reports have appeared on leukopenia/agranulocytosis related to almost all drugs used in the treatment of hypertension, none of these drugs seem to be especially prone to cause any damage to leukocytes and/or leukocyte production.

Agranulocytosis↗
PubMed1979

On the physiological and clinical significance of a trapezius reflex evoked by tapping the spine.

On routine clinical examination it was observed that precussion over the thoracic spine occasionally produced reflex contraction of the intermediate and caudal parts of the trapezius muscle. The observation was made in one case of spondylitis and one case of inflammatory connective tissue disorder. Both patients had pain in the thoracolumbar regions. The neurophysiological features of this reflex have been analyzed. The incidence of the phenomenon in a randomly selected normal material was 3%. Electromyographic recording from the trapezius muscle demonstrated that the reflex is present at a subthreshold level in subjects not exhibiting the clinical reflex. The latter is established by pain and/or tension in the thoracolumbar paravertebral region.

Adult↗
PubMed1979

Age variations in normal human contrast sensitivity.

The visual contrast sensitivity (the reciprocal of contrast threshold) was studied as a function of age. Psychophysical measurements of binocular and monocular contrast thresholds were made for 33 normal observers at spatial frequencies within the range 0.5 to 40 cycles/degree. The observers were divided into three different age groups: young, middle-aged, and old subjects with the age ranges 6--10 years, 20--40 years, and 60--70 years, respectively. All observers had healthy eyes, normal vision, and Snellen visual acuity of 1.0 or better in both eyes. In all groups, contrast sensitivity for binocular and monocular viewing peaked at a spatial frequency around 3--5 cycles/degree and showed the typical attenuation at low and high spatial frequencies. The binocular contrast sensitivity was higher than the monocular. There was no significant difference between young and middle-aged subjects with regard to contrast sensitivity. Subjects aged 60 years or more showed significantly lower contrast sensitivity than younger subjects for most spatial frequencies above 4 cycles/degree. We may thus conclude that both the binocular and monocular contrast sensitivity seemed independent of age within the range of 6 to 40 years. For higher ages studied (above 60 years), there was a loss of sensitivity in the middle and high frequency regions.

Adolescent↗
PubMed1978

Oxymetholone treatment in myelofibrosis.

In order to study the effect of oxymetholone therapy in advanced myelofibrosis, 11 patients (4 females, 7 males) were given, 3--5 mg per kg body weight, long-term oxymetholone treatment in a prospective multicenter study. Five cases had previously had a diagnosis of polycythemia vera. All patients had anemia initially, 4 leukocytopenia and 10 thrombocytopenia in addition. Hepato-splenomegaly was present in all cases but in varying degree. Five patients required regular blood transfusions before treatment. In 9 of the 15 courses given, there was normalization of the peripheral blood or substantial improvement (better than 3 g hemoglobin/dl or 50 X 10(9) platelets/1) after androgens. Significant effects were noted both on hemoglobin values and platelet counts. The need for blood transfusions ceased completely in all 5 cases. When oxymetholone treatment was reduced or interrupted 4 patients relapsed; 2 of them responded to a renewed course. The red cell counts returned to previous polycythemic values in one patient and another died from acute leukemia. The results of this study suggest that androgens might be of value in advanced cases of myelofibrosis with transfusion-requiring anemia or severe thrombocytopenia.

Aged↗
PubMed1978

A new method for determination of microsomal haem oxygenase (EC 1.14.99.3) based on quantitation of carbon monoxide formation.

Microsomal haem oxygenase (MHO) catalyses the main pathway for haem degradation. Hitherto bilirubin formation rate (BFR) has been used for determination of MHO activity. In the present study a method is described where MHO activity is assessed from the rate of carbon monoxide formation (VCO) in tissue homogenates with methaemalbumin as substrate. Formed CO is bound to haemoglobin present in the tissue homogenate. CO is measured by gas chromatography after reduction to methane. CO amounts of 0.01 nmol could be measured. This corresponded to an MHO activity of 0.05 pkat when using standard incubation mixture and 12 min incubation time. The correlation with MHO activity determined with the BFR technique was good (r = 0.94; n = 41); MHOVCO = 0.94-MHOBFR-0.08). Advantages with the VCO method are a ten-fold increase in sensitivity compared to the BFR method and independence of biliverdin reductase.

Animals↗
PubMed1977

Heme catabolism in liver cirrhosis with portal hypertension after shunt surgery.

Endogenous production of carbon monoxide (VCO), total and direct reacting serum bilirubin (TSB, DRB) were determined in 26 patients with liver cirrhosis and portal hypertension to evaluate the effect of various shunt operations on total heme catabolism. The material was divided into 3 groups. In group I, 11 patients not operated upon, mean VCO (+/- S.D.) was 18.4 +/- 6.0 micronmol/mmol total body heme per day (reference value 12.6 +/- 2.9). In group tii, 7 patients operated upon with subcutaneous transposition and a subtotal resection of the spleen, mean VCO (14.4 +/- 4.7) was not significantly raised. In group III, 8 patients operated upon with a modified distal splenorenal shunt, the highest mean VCO (26.1 +/- 9.0) was found. Mean TSB in the three groups was 34.8 +/- 29.2, 11.2 +/- 3.0, and 46.4 +/- 41.0 micronmol/l, respectively, and mean DRB 18.2 +/- 20.8, 3.7 +/- 1.0, and 26.8 +/- 34.1 micronmol/l, respectively. Estimated from preoperative laboratory values there was no difference in liver function between the three groups. The conclusion drawn is that heme catabolism, increased by 50% in liver cirrhosis complicated by portal hypertension probably due to a slight decrease in erythrocyte survival, tends to normalize after subcutaneous transposition and subtotal resection of the spleen. After spleno-renal shunting, on the other hand, a further increase in heme catabolism is seen. And so the increase in serum bilirubin often seen after the latter type of surgery is mainly related to a raised bilirubin production and not to a further decrease in liver function.

Adult↗
PubMed1976

Carbon monoxide blood levels and reported cessation of smoking.

The carboxyhemoglobin (COHb) level was estimated in patients attending an anti-smoking clinic. A surprisingly large fraction of patients that reported "no smoking" were found to have abnormally high COHb. We believe that this discrepancy is due to the patients not reporting their smoking habits correctly. This phenomenon is further evidence that smoking should be regarded as a form of drug addiction in some persons. Some early relapses in stop-smoking programs can apparently be explained by the patient's admitting previously concealed smoking. For scientific purposes the results of stop-smoking cures should be evaluated by other means than the patient's own reports.

Carbon Monoxide↗
PubMed1976

Erythropoiesis and carbon monoxide production in Hodgkin's disease.

Endogenous production of carbon monoxide (VCO), red cell survival and iron kinetics were studied in 15 subjects with Hodgkin's disease. The subjects were divided into two groups, namely: eight patients with anaemia (group A, haemoglobin (Hb) concentration less than 11.5 g/dl) and seven patients without anaemia (group B, Hb concentration greater than 11.5 g/dl). Red cell survival was not significantly different in the two groups being 91 +/- 40 days (mean +/- 1 SD) in group A and 111 +/- 54 days in group B. Relative VCO (mumol/mmol total body haem (TBH/d) was, however, significantly higher (0.01 greater than P greater than 0.001) in group A (20.7 +/- 4.7) compared to group B (12.0 +/- 3.8). When absolute VCO (mumol/d) was compared to the daily turnover of circulating red cell haemoglobin haem (Vhaem-c), the VCO/Vhaem-c quotient was 2.1 +/- 0.9 in group A and 1.2 +/- 0.3 in group B. Erythron turnover of iron (ET, mumol Fe/mmol TBH/d) was calculated through subtraction of the non-erythron turnover (NET) from the total plasma iron turnover (PIT). ET was significantly higher (0.05 greater than P greater than 0.01) in group A (39 +/- 21) than in group B (20 +/- 8). The conclusion drawn from the finding of significant increases in VCO and ET without and concomitant significant decrease in red cell survival in the anaemia group is that ineffective erythropoiesis, i.e. bone marrow haemolysis, seems to play an important role in the anaemia of Hodgkin's disease.

Adolescent↗
PubMed1976

Carbon monoxide production in patients with breast carcinoma.

Total haem catabolism has been studied through measurement of endogenous production of carbon monoxide (VCO) in 19 patients treated for breast carcinoma. The subjects were divided into three groups. Group A included six patients with haemoglobin (Hb) concentration greater than 11.5 g/dl and considered free from disease. Group B consisted of seven patients with distant metastases and Hb concentration greater than 11.5 g/dl and group C of six patients with distant metastases and anaemia (Hb concentration less than 11.5 g/dl). VCO in group A was 10.3 +/- 3.7 (mean +/- 1 SD) and in group B 9.0 +/- 2.5 mumol/mmol total body haem (TBH)/d. These values are not different from our normal values of 10.8 +/- 2.8 mumol/mmol TBH/d. In group C VCO was 21.1 +/- 3.1 (an increase of 100%). VCO was compared to daily catabolism of circulating red cell haemoglobin haem (Vhaem-c) in the VCO/Vhaem-c quotient. Vhaem-c was calculated from total circulating red cell haemoglobin haem (TBHb-c) and red cell survival. In group A and group B this quotient was 1.3 +/- 0.6 and 1.1 +/- 0.2, respectively, and in group C was 2.5 +/- 0.9. The difference between group A and B on one side and group C on the other side was significant (P less than 0.001). The 'extra' CO produced in patients with anaemia and disseminated disease (group C) was thought to originate from increased turnover of bone marrow haem, reflecting considerable ineffective erythropoiesis with destruction of haemoglobinized immature red cells. The results confirm earlier findings of a high VCO/Vhaem-c quotients in patients with anaemia secondary to Hodgkin's disease.

Adult↗
PubMed1976

Erythrocyte filterability and heme catabolism during the menstrual cycle.

Erythrocyte filterability, reticulocyte count, total serum bilirubin, and CO hemoglobin percent saturation (COHb) were measured throughout one menstrual cycle in 17 women. The filterability was significantly depressed during the progesterone phase compared with the estrogen phase. The depressed filterability was accompanied by significant increases in reticulocyte count, total serum bilirubin, and COHb. Significant correlations were seen between filterability, reticulocyte count, and total serum bilirubin. However, COHb did not correlate significantly with any of the other variables studied. This is probably due to increased ventilation during the progesterone phase balancing the increased endogenous production of CO. It is possible that cyclic variations in heme turnover are related to changes in erythrocyte characteristics during the progesterone phase.

Adult↗
PubMed1976

Oxymetholone treatment in aregenerative anaemia. II. Remission and survival--a prospective study.

This is a prospective multi-center study in which patients with aregenerative anaemia were treated with a standardized high dosage regime of an anabolic steroid (oxymetholone, Anasteron). 53 patients were included and divided into two groups according to bone marrow cellularity. Furthermore the hypocellular group was subdivided in order to make comparison with earlier studies possible. In the hypocellular group, the frequency of remission was 56% and the 2-year-survival from the onset of symptoms was 75%. This is longer than in some earlier studies, perhaps because of possible differences in etiology and/or because of the effect of systematic high dosage, long term androgen therapy. Patient selection was minimized and was not considered to be of major importance. Patients with hypercellular marrows, on the other hand, responded poorly to androgens. In this group 63% died of acute leukaemia, which confirms earlier suggestions that this form of aregenerative anaemia, frequently is of a preleukaemic nature.

Adolescent↗
PubMed1976

Glucose administration and heme catabolism after caloric restriction.

Heme catabolism was monitored through the determination of total serum bilirubin and endogenous production of carbon monoxide in 6 healthy males before and after administration of 100 g of glucose orally and intravenously, respectively. To facilitate comparison, hyperbilirubinemia was induced through a 36-hr period of subtotal caloric restriction before the study. A decrease in production of carbon monoxide was seen after glucose given orally as well as intravenously, whereas total serum bilirubin decreased significantly only after glucose orally. It is suggested that oral as well as intravenous glucose administration temporarily inhibits heme catabolism, at least when given after a period of caloric restriction. In addition, oral glucose might have--probably via a gut-related factor--a facilitating effect on liver uptake of bilirubin.

Administration, Oral↗
PubMed1975

Heme catabolism, carbon monoxide production and red cell survival in anemia.

Total heme catabolism has been studied through measurement of the endogenous production of carbon monoxide (VCO) in 8 patients with hemolysis, 7 with hypoproliferative anemia, 10 with refractory anemia and hypercellular bone marrow and 7 with splenomegaly, 6 of whom had myeloid metaplasia. Simultaneously, catabolism of circulating red cell hemoglobin heme (Vheme-c) was measured through labelling of the red cells with 51Cr, and the VCA/Vheme-c ratio was calculated for each patient. From a control group it was calculated that this ratio should vary around 1.5. Since no isotope studies were performed in the control group, no range could be defined. Among patients with hemolysis the VCO/Vheme-c ratio was found to vary between 1.3 and 1.8 except in 2 cases of paroxysmal nocturnal hemoglobinuria (PNH) and PNH?, respectively, in whom the ratios were found to be 0.6 and 0.7 suggesting some heme catabolism without corresponding CO formation. In the hypoproliferative group the ratio varied between 1.2 and 1.8 except in one patient treated with androgens, in whom the ratio was found to be 2.9, suggesting increased extraerythrocytic heme turnover. In patients with myeloid metaplasia the ratio varied between 1.3 and 1.8. On the other hand, the ratio varied getween 2.4 and 3.0 among patients with refractory anemia and hypercellular bone marrow, thus confirming earlier findings that in this type of anemia turnover of bone marrow heme is markedly increased. A significant correlation was found between VCO and initial morning COHb%(r equals 0.84). The conclusions drawn are (a) that Vheme-c sometimes represents less than 50% of total heme turnover and (b) that COHb and/or VCO reflect total heme turnover except in patients with blood loss or intravascular hemolysis with hemoglobinuria.

Adolescent↗