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Biomedical subjects

E Moberg

Publications and source records attributed to E Moberg.

At least 37 records · Page 2Linked to original sources
PubMed1991

Long-term effects of radiotherapy and bromocriptine treatment in patients with previous surgery for macroprolactinomas.

The long-term effect of radiotherapy and bromocriptine treatment was retrospectively evaluated in 25 patients who had previously undergone transsphenoidal surgery for treatment of macroprolactinomas. Surgery had reduced the median serum prolactin (PRL) value from 613 micrograms/l, a reduction of 53%. Postoperative bromocriptine was administered to 21 of the 25 patients. In 14 of these patients, serum PRL values became normal or almost normal with medication. There were no radiological or ophthalmological signs of progressive tumor growth during bromocriptine treatment. Fourteen patients received postoperative radiotherapy. After withdrawal of bromocriptine in 13 of these patients an average of 7 years after radiotherapy, the median serum PRL value had further decreased by 95%. The PRL reduction was similar for all doses applied, 38 to 52 Gy. After withdrawal of bromocriptine in 8 patients not receiving radiotherapy an average of 7 years after operation, the median serum PRL level had further decreased by 75%. At follow-up, 18 additional instances of pituitary insufficiency had developed in the group receiving radiotherapy, compared with 8 cases of insufficiency in the group not receiving radiotherapy. Thus, because bromocriptine has a long-standing effect on prolactin secretion, and radiotherapy is associated with a notably high incidence of pituitary insufficiency, we propose that photon irradiation should be considered mainly for patients who are not candidates for surgical or medical treatment.

Adult↗
PubMed1991

A high concentration of circulating insulin suppresses the glucagon response to hypoglycemia in normal man.

In an attempt to clarify whether circulating insulin per se exerts an inhibitory effect on the hormonal responses to hypoglycemia, with special emphasis on glucagon secretion, nine healthy volunteers were exposed to low dose (244 pmol/kg.h) and high dose (1034 pmol/kg.h) iv insulin infusions for 3 h on two separate occasions. A close to identical arterial hypoglycemia of about 3.4 mmo/L was obtained in both tests by glucose clamping during the high dose test. The corresponding glucose concentration in the venous blood was significantly lower in the high dose test (2.5 +/- 0.1 vs. 3.0 +/- 0.1 mmol/L; P less than 0.01), while the plasma free insulin level was 4 times higher in the high dose test (897 +/- 50 vs. 208 +/- 14 pmol/L). Plasma glucagon was elevated in both experiments, but its rise was reduced during the high dose test after 1 h, yielding an incremental area under the glucagon curve that was significantly smaller than that obtained during the low dose test (213 +/- 70 vs. 348 +/- 81 ng/L.h; P less than 0.05). The plasma adrenaline, noradrenaline, GH, C-peptide, pancreatic polypeptide, and somatostatin profiles were similar in the two tests. We conclude that an inhibitory effect of circulating insulin on the glucagon response to hypoglycemia can be demonstrated in normal man during an infusion of insulin yielding a plasma concentration of about 900 pmol/L. The responses of other hormones studied are not significantly influenced by the circulating insulin level.

Adult↗
PubMed1990

Exogenous somatostatin raises plasma insulin levels in patients with insulin-dependent diabetes mellitus.

The effect of cyclic somatostatin on circulating insulin levels was studied in eight patients with insulin-dependent diabetes mellitus (IDDM). The study was performed after an overnight fast when their subcutaneous depots of insulin had been depleted during i.v. insulin substitution for 18 hours. A constant rate i.v. insulin infusion (0.4 mU/kg/min) was given for 240 min and somatostatin was co-infused between 60-120 min (100 micrograms/h) and 180-240 min (250 micrograms/h) respectively. Plasma insulin, blood glucose and hematocrit were measured at 15 min intervals. Hematocrit fell from 41.7 to 38.3% during the study period. Somatostatin increased the plasma insulin levels, corrected for the changes of hematocrit, by approximately 8% in the low dose (P less than 0.05) as well as in the high dose (P less than 0.05) period. It is concluded that somatostatin interferes with the clearance of insulin thereby increasing the circulating plasma insulin levels in IDDM patients without residual insulin secretion.

Adult↗
PubMed1990

Two-point discrimination test. A valuable part of hand surgical rehabilitation, e.g. in tetraplegia.

In assessing the prospects for surgical and other kinds of rehabilitation in tetraplegia and stroke patients the two-point discrimination test, correctly performed by experienced examiners, is of great value. Valid and repeatable results depend on exact technique and proper tools. There is a firm correlation between the thresholds of two-point discrimination on the pulps of the fingers and the accuracy of position sense at the metacarpophalangeal and interphalangeal joints. Microneurography has shown that cutaneous receptors have proprioceptive as well as exteroceptive functions. Thus the two-point discrimination test can be used as a measure of proprioceptive function. The results can be expressed numerically. A two-point threshold less than 10 mm on the pulp is a valid measure of useful finger proprioception. It also shows tactile gnosis, necessary for precision sensory grips.

Differential Threshold↗
PubMed1987

Misleading T3-test values in psychiatric patients treated with orphenadrine.

Thyroid laboratory tests were assessed in 74 psychiatric patients without clinical evidence of overt thyroid disorder. In a first screening of 42 patients, 13 were found to have elevated levels of triiodothyronine uptake test (T3-test) by a Sephadex method. Ten of these patients also had an elevated free thyroxine index (fT4-index). Of the 13 patients with increased T3-test values, 10 were on orphenadrine (Disipal) treatment or had recently stopped taking the drug. In a second study, thyroid function tests were compared in 15 pairs of matched psychiatric patients treated with orphenadrine or other anticholinergic drugs. Values of T3-test and free thyroxine index were significantly higher among patients treated with orphenadrine. Finally, orphenadrine was instituted in four patients and withdrawn in six patients. T3-test values and free thyroxine indices increased gradually after orphenadrine treatment had been initiated and decreased gradually when it was withdrawn.

Adult↗
PubMed1985

New facts about hand control-kinaesthesia.

In the cases of major losses, kinaesthesia has to be evaluated in reconstructive arm and hand surgery if adequate functional results are to be obtained. Differing from earlier teaching, experimental work has shown that the dominating afferent receptor system for proprioception is located in the skin, not in joints or in the musculotendineous system. This fact must be taken in account in planning surgery as well as in the following (re-)education and training.

Afferent Pathways↗
PubMed1984

A long-term study of the effect of early synovectomy in rheumatoid arthritis.

Joint recurrence of rheumatoid arthritis following synovectomy is often due to residual rheumatoid granulations within the spongiosa of the bone. This occurs much earlier than heretofore believed. Early synovectomy can often prevent local progression of the disease process. The regrowing fibrous lining after almost total and very early synovectomy does not have the ability to form rheumatoid granulations.

Adult↗
PubMed1983

The role of cutaneous afferents in position sense, kinaesthesia, and motor function of the hand.

In reconstructive surgery and rehabilitation work, for decades it has been a basic problem for the author to discover which of the peripheral receptor systems provide the primary information on position, motion and degree of load (proprioception). At one time, joint receptors were accepted as the dominant source and more recently musculocutaneous receptors, whereas little attention has been given to cutaneous factors. A number of clinical observations, however, have indicated the importance of cutaneous afferents and this prompted the present study. There are no means of isolating the joint receptors in order to test them alone, but the fact that very good kinaesthesia can be present in their absence militates against their importance. The cutaneous and musculotendinous factors were therefore studied independently in the forearm and hand in test subjects, partly by means of an extensive nerve blocking technique, but also in experiments of the type devised by Gelfan and Carter (1967). The latter proved to be much less simple than had earlier been claimed. The results of the experiments indicated that no kinaesthetic information reaching conscious level could be shown to arise from the musculocutaneous system, whereas the cutaneous afferents appeared to provide the dominant input. As this system can be readily examined and can be moved surgically to parts in need of proprioception, the practical consequences are obvious. It was also observed that signals arising from skin that is displaced over contracting muscle bellies or moving tendons remote from the activated parts of the limb could constitute an important source of error, overlooked in earlier studies.

Adult↗
PubMed1981

Traumatic injuries to the brachial plexus.

Transient lesions of the brachial plexus are fairly common but are difficult to recognize early because of other associated severe injuries of the brain and skeleton. They often cause hand edema, producing stiffness. In recent years, the understanding of the role of afferent sensory impulses and the application of microsurgical technique has helped in development of newer methods for surgical rehabilitation of the arm and hand. However, repair of the brachial plexus has to be supplemented by sequential reconstruction designed to restore the function of the shoulder, elbow, and hand. Although the diagnosis and treatment have to be individualized, the reconstruction must begin with the hand, in which time is of the essence and the sequelae of untreated edema, stiffening of the joint, and immobility of gliding tissues may result in irreversible rigidity. The methods used in restoration of prehension and moving grip of the hand, as well as various procedures for reconstruction of the elbow and the shoulder, have been presented with their application in four patients, illustrating the different approaches and final function.

Adult↗
PubMed1976

Reconstructive hand surgery in tetraplegia, stroke, and cerebral palsy: some basic concepts in physiology and neurology.

The examination of hands in tetraplegia, stroke, and cerebral palsy must include evaluation of the state of the ligaments the muscles available for motors for tendon transfer, and, most important, the areas of sensibility. The test for two point discrimination is the most valuable in providing information regarding both exteroception and proprioception. Done properly, this test provides more useful information than any other used currently.

Afferent Pathways↗