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Biomedical subjects

G Westberg

Publications and source records attributed to G Westberg.

At least 55 records · Page 3Linked to original sources
PubMed1984

Captopril treatment of hypertension and renal failure in systemic lupus erythematosus.

Captopril, an angiotensin-converting enzyme inhibitor, was used to treat 14 patients with lupus nephritis and severe hypertension. All patients had reduced renal function and were on regular immunosuppressive therapy with corticosteroids and azathioprine. The initial dosage of captopril was reduced according to the level of renal impairment. 11 patients were treated for more than 6 months. Excellent blood pressure control was achieved with captopril, from a mean of 178 +/- 7/110 +/- 4 to 145 +/- 5/92 +/- 3 mm Hg at 6 months, usually in combination with a diuretic only. In 5 cases, a beta-blocker was added. In 3 patients, captopril therapy was discontinued within the 1st month of treatment. 1 patient did not respond to captopril at all; 1 patient had a rejection crisis and required dialysis; in 1 case, a general exanthema developed within 3 weeks and captopril medication was stopped. In addition to blood pressure control, renal function improved in 7 of the long-term-treated patients (mean increase in glomerular filtration rate 73 +/- 34%). In 3 patients, a continued slow deterioration renal function occurred, and in 1 patient, renal function remained unchanged. It is concluded that captopril is an effective antihypertensive drug in patients with systemic lupus erythematosus (SLE). Captopril treatment increased renal function in 64% of patients on long-term therapy. Not only optimal blood pressure control but other factors may also contribute to this beneficial effect, such as drug-induced prostaglandin release potentiating immunosuppressive treatment. Captopril may in fact be the drug of choice for the treatment of SLE patients with severe hypertension.

Adolescent↗
PubMed1984

Quantitative studies of glomerular ultrastructure in human and experimental diabetes.

A brief review is given of glomerular structural changes in diabetes mellitus and in rats with induced diabetes. The stereological methods for obtaining quantitative structural data are mentioned, and references are given to the underlying theories as well as to more detailed descriptions of the practical performance. In short-term diabetes a glomerular hypertrophy is found with increase in the surface area of the capillaries, in parallel with an increase in glomerular filtration. In long-term diabetes mellitus the picture is dominated by accumulations of basement membrane: thickening of the peripheral basement membrane and expansion of the mesangial regions which hold large amounts of basement membrane material. Rats with a moderate diabetes show the early hypertrophy as well as long-term basement membrane thickening. Severely diabetic rats develop basement membrane thickening but do not show the early hypertrophy, which is therefore not a necessary condition for basement membrane thickening to occur.

Adult↗
PubMed1983

Diabetic glomerulopathy. Structural characteristics of the early and advanced stages.

Studies of the glomerular structure in diabetes mellitus have helped to elucidate the basis for some functional abnormalities. The decline in glomerular filtration occurring in many long-term diabetics is a functional disorder of great clinical importance. Quantitative structural studies of the glomeruli in diabetics at different stages of disease are necessary to learn about the development of structural changes leading to the end-stage kidney disease. Preliminary results of a study of glomeruli from long-term diabetics with clinical nephropathy are compared with those obtained in control subjects and in diabetics within the first 5 yr of disease. In the long-term diabetics the peripheral basement membrane thickness was doubled. On the average, mesangial regions occupied nearly 60% of the total tuft volume as compared with 33% in the early stages. A marked accumulation of basement membrane material in the mesengial regions had taken place so that 85% of the total basement membrane material of the tufts (i.e., peripheral basement membrane in the capillary walls plus mesangial basement membrane-like material) was localized within the mesangial regions. In the early stages equal amounts were found at these two different sites. The distribution of the lesions within the kidney is under investigation in a light microscopic study of autopsy material from long-term diabetics with varying degrees of glomerulopathy. The severity of the diabetic glomerulopathy was quantitated separately within the superficial and the deep cortical zones. The results showed that there was no tendency toward increased severity in the deep glomeruli.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1982

Interferon and natural killer cells in systemic lupus erythematosus.

Natural killer (NK) cell activity against several types of target cells was found to be subnormal in patients with systemic lupus erythematosus (SLE). Interferon (IFN) boosted the NK activity of cells from SLE patients to a significantly lesser degree than cells from normal controls. The production of IFN after stimulation of blood cells with Sendai virus was significantly decreased in SLE patients with active disease, and in a substantial proportion of the patients the production of phytohaemagglutinin (PHA)-induced IFN was below normal limits. Although the production of virus-induced IFN was clearly inversely correlated to disease activity no such correlation was observed for PHA-induced IFN. Serum levels of both pH2 stable and pH2 labile IFN were significantly higher in SLE patients than in controls. The findings clearly show that SLE is associated with abnormalities in the NK cell-IFN system but it cannot be stated whether these abnormalities are causally related to the development of disease or are secondary to pathological changes in SLE.

Adolescent↗
PubMed1980

Spontaneous dissolution of gallstones. A case report.

Spontaneous dissolution of gallstones is seldom observed. According to present knowledge the maximum spontaneous disappearance rate of radiolucent stones should be less than one per cent per year. The present paper reports on the gradual disappearance of multiple gallstones, probably by dissolution, in an elderly woman. Possible contributing factors are discussed.

Aged↗
PubMed1979

Effect of Sar1-ala8-angiotensin II on blood pressure and renin in Bartter's syndrome, before and after treatment with prostaglandin synthetase inhibitors.

Three patients suffering from Bartter's syndrome were studied before and after 5 days of treatment with the prostaglandin synthetase inhibitors, aspirin and indomethacin. Saralasin was given by intravenous infusion in increasing doses from 0.6 to 42 micrograms/min.kg/BW. During saralasin infusion a blood pressure reduction was observed in all patients. Aspirin treatment did not affect this response and nor did it affect other manifestations of the syndrome. Indomethacin treatment changed the blood pressure response to saralasin in such a way that the blood pressure was increased in one patient and was unchanged in the other. Indomethacin also tended to normalize other features of Bartter's syndrome, such as the hyperreninaemia and angiotensin unresponsiveness, but did not affect the hypokalaemia. The saralsin effect on blood pressure is thus evidently inversely related to the prevailing activity of the renin-angiotensin system in this condition also, and the patients obviously depended on the renin-angiotensin system to maintain their blood pressure. Our findings, together with data in the literature, indicate that angiotensin unresponsiveness of the vascular bed is not a primary feature in Bartter's syndrome. Chloride loss is currently thought to be the basic abnormality and this may link the Bartter's syndrome with other diseased states characterized by chloride loss, such as the syndrome of habitual vomiting and chronic treatment with loop diuretics.

Adolescent↗