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Biomedical subjects

H Kvist

Publications and source records attributed to H Kvist.

At least 37 records · Page 2Linked to original sources
PubMed1990

Visceral fat accumulation in men is positively associated with insulin, glucose, and C-peptide levels, but negatively with testosterone levels.

Twenty-three healthy men (age 25 to 50 years), covering a wide range of fatness and body fat distribution, were studied. An oral glucose tolerance test was performed and adipose tissue areas were calculated from computed tomography (CT) scans made at the level of L4/L5. Visceral fat area was associated with elevated concentrations of insulin and C-peptide and with glucose intolerance before and after the oral glucose load. Concentrations of sex-hormone-binding globulin (SHBG), as well as total and free testosterone, were negatively correlated with waist/hip circumference ratio and visceral fat area and also negatively associated with increased glucose, insulin, and C-peptide concentrations. In multiple linear regression, adjusting for age, body mass index, and visceral fat area, serum concentrations of free testosterone were still negatively correlated with glucose, insulin, and C-peptide levels. Without claiming any causality in the observed associations, we conclude that, unlike in women, abdominal fat distribution, insulin, glucose, and C-peptide levels are negatively associated with serum testosterone levels in men.

Adipose Tissue↗
PubMed1990

Effects of thoracic epidural anesthesia on coronary arteries and arterioles in patients with coronary artery disease.

The effect of cardiac sympathetic blockade by high thoracic epidural anesthesia (TEA) (T1-T6, bupivacaine) on the luminal diameter of normal and diseased portions of epicardial coronary arteries was determined by quantitative coronary angiography in patients (n = 27) with severe coronary artery disease (CAD). In a separate group of patients (n = 9) with severe CAD, the effects of TEA on coronary arterioles (resistance vessels) were studied, by measuring total and regional myocardial blood flow and metabolism with the retrograde coronary sinus thermodilution technique. At the stenotic segments, TEA induced an increase in luminal diameter from 1.34 +/- 0.11 to 1.56 +/- 0.13 mm (P less than 0.002), but did not change the diameter of the nonstenotic segments (3.07 +/- 0.13 to 2.99 +/- 0.13 mm). In the second group of patients, TEA induced no changes in coronary perfusion pressure, total or regional myocardial blood flow, coronary venous oxygen content, coronary blood flow distribution, regional myocardial oxygen consumption, or lactate extraction or uptake. Two patients had chest pain in the control situation and had regional myocardial lactate production that was attenuated by TEA. We conclude that TEA may increase the diameter of stenotic epicardial coronary artery segments in patients with CAD without causing a dilation of coronary arterioles. These effects may be beneficial when high TEA is used to treat severe ischemic chest pain in patients at rest.

Aged↗
PubMed1989

Regional distribution of muscle and fat mass in men--new insight into the risk of abdominal obesity using computed tomography.

We studied 24 healthy men (25-50 years old) covering a wide range of fatness (body mass index range: 21-34 kg/m2) and fat distribution (waist/hip range: 0.75-1.06). Computed tomography scans were taken at five levels (thigh, hip, waist, arm, and liver) from which fat, muscle and bone areas were calculated. Both waist/hip and BMI were correlated with fat areas in the thigh, arm and waist scans. BMI showed stronger correlations with peripheral fat areas, whereas waist/hip showed stronger correlations with fat areas in the waist scan (particularly with visceral fat area: r = 0.88, P less than 0.001). BMI was correlated with muscle and bone areas in the thigh scan. In multiple regression BMI was, independently of waist/hip and age, positively correlated with fat areas in the arm, thigh, and waist (not with visceral fat) and muscle and bone areas in the thigh. Waist/hip was independently of BMI and age correlated with fat areas in the arm and waist, including visceral fat area (but not with fat areas in the thigh). Moreover, waist/hip showed an independent negative correlation with muscle area in the thigh, muscle endurance and physical activity. Serum triglycerides, plasma insulin, glucose, uric acid and diastolic and systolic blood pressure were associated with visceral fat area but also to anthropometric indicators of abdominal fat distribution (especially waist/hip ratio). Liver attenuation, but not the liver/spleen attenuation ratio, was associated with some liver enzymes and BMI but not with waist/hip or metabolic parameters. We conclude that a higher BMI is associated with increased central and peripheral fat stores (but not visceral fat) and increased thigh muscle whereas waist/hip is primarily associated with increased central fat stores (noteably with visceral fat), decreased thigh muscle and reduced physical fitness. It is suggested that physical training might be an important element in the treatment of abdominal obesity in men.

Abdomen↗
PubMed1988

Total and visceral adipose-tissue volumes derived from measurements with computed tomography in adult men and women: predictive equations.

Total and visceral adipose-tissue (AT) volumes were determined by computed tomography (CT) by a multiscan technique in 17 men and 10 women with a wide range of body weights. In these primary materials, weight, height, and various diameters, circumferences, and subcutaneous AT thicknesses of the trunk were examined for their relationships to CT-determined total and visceral AT volumes. Predictive AT equations from the primary materials were then tested on two cross-validation groups consisting of another 7 men and 9 women. For the prediction of the total AT volume, weight/height was the superior single predictor, with errors less than 11% in primary and cross-validation materials. For the prediction of visceral AT volume, simple equations based entirely on the sagittal diameter of the trunk at the L3-L5 level resulted in errors less than 21% in both sexes.

Adipose Tissue↗
PubMed1988

Adipose tissue volume determination in males by computed tomography and 40K.

Seventeen healthy male volunteers with weights ranging from 54 to 145 kg were examined with a Philips Tomoscan 310. The upper attenuation limit of adipose tissue was determined to be -30 HU. The lower attenuation limit was set to -190 HU. Regional and total adipose tissue volumes were calculated from the adipose tissue areas of 22 scans and from the distances between these scans. Three different mathematical formulas were used, which all gave similar results. The adipose tissue area of several trunk scans, as well as the elbow, showed very high correlations (r greater than 0.96) versus the volume determinations based on 22 scans. The visceral adipose tissue area of scan L2-L3 showed a higher correlation (r = 0.986) than any other single scan versus the visceral adipose tissue volume. Total adipose tissue volume determinations with ten selected scans correlated very closely with the results obtained from 22 scans (r = 0.997). The adipose tissue volume of the head and neck region was 1.9 +/- 1.0 per cent of the total volume. Corresponding figures for other regions were: arms 6.8 +/- 1.0 per cent, legs 29.0 +/- 7.3 per cent, subcutaneous part of the trunk 41.4 +/- 7.4 per cent and the visceral region 20.9 +/- 7.0 per cent. With greater total adipose tissue volumes the percentage of the subcutaneous adipose tissue of the trunk increased (r = 0.686; P less than 0.005). There was a very strong negative relationship between the fractional amount of adipose tissue in the legs and in the trunk (r = 0.993, P less than 0.001). The potassium contents of fat-free mass and lean body mass were deduced to be 64.7 and 71.0 mmol/kg, respectively. These calculations were based on adipose tissue volume determinations by computed tomography, on 40K measurements and on the assumption that the volume proportions of fat, water and protein in adipose tissue were 85:13.7:1.3. By using computed tomography (CT) as a standard an optimal weight (W) for height (H) index was constructed by using an iterative correlation technique. The optimal index, i.e. highest correlation and lowest error versus ATCT was found for W/H0.9.

Adipose Tissue↗
PubMed1987

Chronic Achilles paratenonitis in athletes: a histological and histochemical study.

Pathological alterations of chronic Achilles paratenonitis were studied histologically and histochemically in tissue samples obtained operatively from 16 athletes with this complaint and from 3 control patients. The activities of 11 different enzymes--lactate, succinate, malate, glucose-6-phosphate and glutamate dehydrogenases, lipoamide dehydrogenase and glutathione reductase (NADH2- and NADPH2-diaphorases), acid and alkaline phosphatases, phosphorylase and leucylaminopeptidase--were studied. Pathological findings were located diffusely around the tendon. A slight inflammatory cell reaction was found in all cases. The fatty areolar tissue was clearly thickened and edematous, and showed fibrinous exudations, widespread fat necrosis, considerable connective tissue proliferation and adhesion formation. The blood vessels showed profound degenerative and necrotizing changes. The thin membranes of the paratenon were clearly hypertrophied. Increased enzyme activities were mainly found in the fibroblasts, inflammatory cells and vascular walls. A moderate activity of lysosomal enzymes, an increased activity of enzymes of electron transport, anaerobic glycolysis, pentose phosphate shunt and decreased activity of those of aerobic energy metabolism were found. Simultaneously an increased amount of both neutral and acid mucopolysaccharides and a locally increased amount of elastic fibres were found in the inflamed paratenon. These results indicate that marked metabolic changes occur in paratenonitis, i.e. an increased catabolism and decreased oxygenation of the inflamed areas. The morphological alterations suggest that the gliding function of the paratenon may be impaired.

Achilles Tendon↗
PubMed1986

Determination of total adipose tissue and body fat in women by computed tomography, 40K, and tritium.

The adipose tissue volumes of 12 women were determined by computed tomography (CT). Body weight ranged from 46 to 129 kg. Nine or twenty-two transsectional scans were examined with respect to the adipose tissue area. The total adipose tissue volume (ATCT22 or ATCT9) was calculated by assuming linear changes in the adipose tissue area between adjacent scans. Body fat (BF) was also calculated from total body potassium (BF40K), from total body water (BFTHO), and from both these determinations (BF40K + THO). Body mass index (BMI) was calculated by dividing body weight (BW) by height2 (H2). ATCT22, ATCT9, and BFK were more closely related to BW and BMI than were BFTHO and BF40K + THO. When ATCT was used as a standard, the optimal index of adiposity based on BW and H was in the range BW/H0.8 to BW/H1.2. From the CT and 40K measurements it was possible to deduce that the potassium content is 62 mmol/kg fat free mass and 73-75 mmol/kg lean body mass. The error of ATCT9 was 0.6%, while that of BF40K was at least three to four times larger. It is concluded that the CT-based AT determination is the most reproducible method so far available. The technique might turn out to be of great value in human energy balance experiments.

Adipose Tissue↗
PubMed1986

Effects of periodic positive airway pressure by mask on postoperative pulmonary function.

Postoperative pulmonary complications, alveolar-arteriolar oxygen difference ([A-a]O2-diff), peak expiratory flow (PEF) and forced vital capacity (FVC) were compared in patients using continuous positive airway pressure (CPAP) and positive expiratory pressure (PEP) administered by face mask against those of a control group using a deep-breathing device (Triflo). Forty-three consecutive, randomized patients undergoing elective upper abdominal surgery were included. CPAP, PEP and Triflo were administered for 30 consecutive breaths in every waking hour for three days postoperatively. The (A-a)O2-difference increased equally and significantly in the three groups after surgery, reaching a maximum on the first postoperative day. After this day, however, (A-a)O2-diff decreased in the CPAP and PEP groups, being significantly lower in the PEP group compared to the control group, two days postoperatively (p less than 0.05) and significantly lower in both the PEP and CPAP groups three days postoperatively (p less than 0.001 and p less than 0.05, respectively.) PEF did not differ significantly between the groups before or after surgery, while FVC was significantly higher in the PEP and CPAP groups, compared to control, on the third postoperative day (p less than 0.05). Atelectatic consolidation was observed in six of 15 patients in the control group three days postoperatively, the incidence being significantly lower in both the PEP group (0 of 15, p less than 0.001) and the CPAP group (one of 13, p less than 0.05). We concluded that periodic face mask administration of CPAP and PEP are superior to deep breathing exercises with respect to gas exchange, preservation of lung volumes and development of atelectasis after upper abdominal surgery. We also conclude that the simple and commercially available PEP mask is as effective as the more complicated CPAP system.

Abdomen↗
PubMed1986

Adipose tissue volume determinations in women by computed tomography: technical considerations.

Eight healthy female volunteers with weights ranging from 46 to 119 kg were examined with a Philips Tomoscan 310 in order to determine the amount of adipose tissue. From analysis of 'attenuation profiles' at the thigh and trunk levels the attenuation interval of adipose tissue was determined to be -190 HU to -30 HU. The adipose tissue volume was calculated from the adipose tissue area of 22 scans and from the distances between these scans. Three different mathematical models were tested which all gave similar results. The adipose tissue surface of the L4-L5 scan showed a higher correlation (r = 0.991) than any other single scan versus the 22-scan-based adipose tissue volume. The adipose tissue volume had to be calculated from nine selected slices in order to agree closely with the results based on 22 scans (r = 0.999) in each individual case. The adipose tissue volume of the head and neck region was 1.7 +/- 0.24 per cent of the total volume, while corresponding figures for other regions were: arms 7.5 +/- 1.2 per cent, legs 31.8 +/- 5.6 per cent, subcutaneous part of the trunk 48.9 +/- 5.1 per cent and visceral region 10.2 +/- 1.7 per cent. The relative amount of subcutaneous trunk adipose tissue increased with increasing adipose tissue volumes while that of legs, and of head and neck tended to decrease. The relative amount of visceral fat was not significantly dependent on the total adipose tissue volume in these eight women.

Adipose Tissue↗
PubMed1985

Fine structural alterations in chronic Achilles paratenonitis in athletes.

The fine structural alterations in chronic Achilles paratenonitis were studied in tissue samples obtained from 14 athletes, who were operated on for this complaint and from 3 patients without any history of this disease. In the chronically inflamed paratendineal tissue mainly two types of cells were identified: classic fibroblasts with a smooth and rough endoplasmic reticulum and only a few mitochondria and lysosomes and myofibroblast-like cells with cytoplasmic microfilaments 5-6 nm in diameter, a rough endoplasmic reticulum, some mitochondrias and free ribosomes. These cells represented 19% of 471 studied non-inflammatory cells. In the extracellular space there was an increased amount of fibrils regarded as either type I or type III collagen as sign of tissue repair. Especially around the myofibroblastic cells a fine granular ground substance was found. The amount of ground substance was as a rule increased in pericellular space. Due to the capacity of contraction in healing tissue the myofibroblasts apparently have a role in the clinical symptoms of chronic Achilles paratenonitis.

Achilles Tendon↗
PubMed1984

Total rupture of pectoralis major muscle in athletes.

Total rupture of the pectoralis major muscle is rare. It may follow a severe trauma or strenuous athletic exercise or performance. Five cases of total rupture of the pectoralis major muscle treated in athletes are reported. Two of them had made an extremely exerted effort in weight lifting, one was injured during a parachute landing, one was tackled in an ice hockey match, and one injured his pectoralis major muscle while pushing himself up from a swimming pool. In two cases the diagnosis was made early and in three cases 2-4 months after the injury. All of the patients were male and were treated successfully with surgery. Later they were able to exercise their sports. The weight lifters did not go on with competitive sports.

Adult↗
PubMed1980

The operative treatment of chronic calcaneal paratenonitis.

The conservative management of chronic calcaneal paratenonitis is time-consuming and often unsatisfactory. A new, safe and simple technique is described. The crural fascia on both sides of the tendon is incised and left open, adhesions around the tendon are trimmed away, the strongly hypertrophied portions of the paratenon are removed and mobilisation is begun immediately after operation. Between 1961 and 1978 201 such operations were performed on 182 patients 62 of whom were top-ranking Finnish athletes. Only five patients were not athletes. The results, including early return to full activity, were excellent in 169, good in 25 and poor in seven cases. After operation one of the patients gained an Olympic gold medal; others have attained international prominence.

Adolescent↗