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Biomedical subjects

H Lund

Publications and source records attributed to H Lund.

At least 55 records · Page 3Linked to original sources

[The admission and discharge patterns of patients with dementia in psychiatric hospitals].

This paper describes the admission and discharge pattern in a psychiatric hospital for 315 senile and arteriosclerotic demented patients (290.09, 293.09 ICD-8) aged 65 years and over and admitted for the first time. 47% (149) of the patients were admitted from other hospitals and temporary stays in nursing homes. A total of 203 (65%) of the patients experienced one or more changes of residence during the three months prior to admission to the psychiatric hospital. A Kaplan-Meier analysis showed that 25% of the patients were still hospitalized 48 weeks after admission. A total of 62 patients died in the psychiatric hospital, one patient was still hospitalized when the investigation ceased. Of those discharged alive 201, (80%) were discharged to nursing homes 26 (10%) to their own homes and 25 (10%) to hospitals. Of those who had their own home at the time of admission and were discharged alive only 16% were discharged to their own homes, the remainder were discharged to nursing homes and hospitals. On account of the many changes of environment the demented patients experience prior to admission to the psychiatric hospital, they risk developing confusional psychoses which may be disastrous to their physical and mental health.

Aged↗

[Use of psychopharmaceuticals and commitment in psychiatric admissions of elderly patients with dementia].

Case records of 404 elderly patients (aged 65 years or more) who were admitted for the first time to the Psychiatric Hospital in Aarhus were investigated retrospectively. In 315 patients the diagnoses were senile dementia (290.09) and arteriosclerotic dementia (293.09) according to ICD-8. Information about use of psychotropic drugs before admission and on discharge alive was obtained from the patient case records. In the present study, the use of drugs was not found to be correlated with age, sex and degree of dementia. Significantly fewer committed patients were treated with psychoactive drugs and significantly fewer lived independently in their own homes. Only 42 (13%) patients had a crude psychiatric disorder while 251 (80%) were admitted on account of unacceptable behaviour. 90% of the latter group of patients had been treated with one or more psychoactive drugs on admission. The risks involved in the use of psychoactive drugs are discussed. On account of demographic changes in the Danish population and the recent decrease in psychiatric hospital beds and nursing home beds, it is recommended that the patterns of committed admissions of demented patients to psychiatric hospitals should be followed closely.

Aged↗

Short-term effects of treatment with simvastatin on testicular function in patients with heterozygous familial hypercholesterolaemia.

The effects of simvastatin 40 mg per day for 14 weeks on the pituitary-testis axis of 19 men with familial hypercholesterolaemia have been examined in a single-blind study. Simvastatin significantly reduced serum low density lipoprotein (LDL) cholesterol and triglycerides by 45% and 30%, respectively, and significantly increased high density lipoprotein (HDL) cholesterol by 15%. The alterations, which were stable 4 weeks after the start of treatment, were not associated with any significant change in sperm quality, the seminal plasma concentrations of various sex gland products (prostate-specific acid phosphatase, polyamines, citrate, fructose, alpha-glucosidase), or the serum concentrations of cortisol, testosterone, LH, FSH, or prolactin. It is concluded that a short-term reduction in circulating LDL-cholesterol has no marked effect on testicular function or sperm quality.

Adult↗

Diagnosis and management of ulnar nerve entrapment.

Ulnar nerve entrapment can be divided into compression at the elbow and the wrist. Etiologies range from direct trauma to metabolic derangements. Guidelines for diagnosis at each site have been presented. Surgical release at the elbow begin at the mid arm where the nerve passes from the anterior to the posterior compartment through the intermuscular septum and extends into the proximal forearm, where it dives down under the heads of the flexor carpi ulnaris. Surgical release at the wrist involves deroofing the canal of Guyon. The authors' preferred methods of release at each site are given along with a description of positive care.

Elbow↗

Long-term effect of retrobulbar hematomas on the vision of cynomolgus monkeys.

Using the monkey model previously developed, we investigated the long-term effects of retrobulbar hematoma-induced retinal ischemia on functional vision and retinal histology. In this experimental model, ischemic periods of up to 120 minutes did not cause permanent visual deficits, as measured by flashed evoked visual potentials. Similarly, retinal histology showed no evidence of ischemic injury. From this we conclude that blindness after blepharoplasty is not due to retrobulbar hematomas alone and that additional predisposing factors are involved. The most likely additional factor is preexisting occult vascular ocular pathology.

Animals↗

Biocompatibility of radiolucent breast implants.

Current implants for breast augmentation containing silicone gel, saline, or both are radiopaque on mammographic examination and can totally obscure microcalcifications and soft-tissue masses. The effect of these implants on the detection of early breast cancers in patients who have undergone augmentation mammaplasty remains unproven and controversial. Implants filled with medium-chain triglycerides (peanut oil) are radiolucent on mammographic examination and allow visualization of both soft-tissue masses and microcalcifications. To investigate the biocompatibility of radiolucent implants, 10 cc of sterile, nonpyrogenic peanut oil was injected subcutaneously into rats using silicone gel as a control. Twenty-one rabbits had two 125-cc silicone shell implants inserted on either side of the chest wall. The right-sided shell was filled with 125 cc of sterile saline, and the left-sided shell was filled with 125 cc of sterile, nonpyrogenic peanut oil. Results were determined by both histologic and radiographic examination. Rats injected with peanut oil equivalent to 7 percent of their body weight rapidly absorbed the freely injected oil without detriment. Histologic examination of the lungs, liver, kidneys, and tissues adjacent to the injection sites demonstrated no abnormalities. There was no evidence of allergic, toxic, inflammatory, or neoplastic response. Eighteen of 21 rabbits survived more than 3 months. Radiographs showed the oil-filled implants to be radiolucent, whereas the saline-filled controls obscured the surrounding soft and bony tissues. Histologic examination demonstrated a fibrous capsule surrounding both types of implants. Histologic examination of the lungs, liver, and kidneys showed no significant abnormalities. These and previous studies have shown peanut oil to be biocompatible when freely injected either intramuscularly or subcutaneously. This study demonstrates that a radiolucent, peanut oil-filled implant is biocompatible in animals and that further long-term studies for its use in humans are merited.

Animals↗

Effect of breast implants on mammography.

We developed an experimental, reproducible method of evaluating the radiographic characteristics of breast implants in vitro using a mammographic phantom and a cadaver. Implant shells tested included smooth silicone, textured silicone, and silicone coated with polyurethane foam. Each type of shell was subsequently filled with saline, silicone gel, and peanut oil; the images were recorded radiographically. Textured silicone and smooth silicone shells minimally impair detection of artifacts. Polyurethane-coated shells are less radiolucent but allow visualization of some microcalcifications. Saline and silicone-gel-filled implants are radiopaque regardless of shell type. Textured silicone and smooth silicone shells filled with peanut oil are radiolucent and allow visualization of microcalcifications and most soft-tissue masses. These data demonstrate that radiolucent breast implants are possible, and further efforts are under way to achieve Food and Drug Administration approval for clinical testing.

Breast↗

Lipoprotein binding and endosomal itinerary of the low density lipoprotein receptor-related protein in rat liver.

The high affinity of 45Ca binding to the low density lipoprotein receptor (LDL-R) and the LDL-R-related protein (LRP) was utilized to study the subcellular distribution of these two proteins in rat liver. Like the LDL-R, LRP was manyfold enriched in rat liver endosomal membranes with a relative distribution in early and late endosomal compartments consistent with recycling between endosomes and the cell surface. The high concentration of LRP in hepatic endosomal membranes greatly facilitated demonstration of Ca-dependent binding of apolipoprotein E- and B-containing lipoproteins in ligand blots. LRP was severalfold more abundant than the LDL-R in hepatic parenchymal cells, showed extensive degradation in hepatic endosomes, and was found in high concentrations in the Golgi apparatus and endoplasmic reticulum. These data suggest a high rate of synthesis of LRP that appeared to be unaffected by treatment of rats with estradiol. The repeating cysteine-rich A-motif found in the ligand-binding domain of LRP appeared to be responsible for Ca binding by LRP, LDL-R, and complement factor C9 and accounted for immunological cross-reactivity among these proteins. Weaker ligand-blotting properties and an extraordinary susceptibility to proteolysis most likely contribute to the difficulty of detecting LRP in conventional assays for lipoprotein receptors. Our data suggest an extensive proteolytic processing of this protein and are consistent with a functional role of LRP in lipoprotein metabolism.

Animals↗

Dietary n-3 fatty acids and children with hyperlipidaemia.

A review of the literature shows that no studies on children with primary genetic lipid disorders have been published. Case reports are presented indicating that hyperlipidaemias presenting in children--both familial hypercholestrolaemia and disorders with secondary hyperlipidaemia (triglycerides) may benefit of the intake of n-3 fatty acids.

Adolescent↗

Immunoregulatory lymphokines in rheumatoid joints. III. B cell growth promoting activity of cells eluted from rheumatoid synovial tissue.

Synovial fluid (SF) from rheumatoid arthritis patients (RA) and culture-supernatants of synovial tissue (ST) cells from RA patients and juvenile rheumatoid arthritis (JRA) patients were examined for their ability to promote B cell growth. SF was not suitable for studying B cell growth promotion because with the anti-mu driven assay system employed, all 15 samples strongly inhibited B cell proliferation. Supernatants of in vitro unstimulated ST cells from RA and JRA patients affected B cell growth in different ways, ranging from strong inhibition to moderate stimulation. Supernatants of unstimulated peripheral blood mononuclear cells (MNC) from healthy donors did not influence B cell proliferation. After phytohaemagglutinin (PHA) stimulation of the ST cells and normal MNC, culture supernatants of RA ST cells and normal MNC all stimulated B-cell growth, while culture supernatants of PHA-stimulated JRA ST cells displayed a variable picture. The differences between PHA-supernatants from RA, JRA and normal MNC were not statistically significant. These results indicate that the inflamed synovia of JRA and RA patients contain cells that can produce soluble factors with B cell growth promoting activity. Some of the data in the study suggest that these factors are produced in vivo and thus might be responsible for the observed B-cell activation in joints of these patients.

Arthritis, Rheumatoid↗

Carnitine palmitoyltransferase: characterization of a labile detergent-extracted malonyl-CoA-sensitive enzyme from rat liver mitochondria.

Rat liver mitochondria were preextracted with Triton X-100 in the absence of salts to remove malonyl-CoA-insensitive carnitine palmitoyltransferase. From the remaining membrane residues a malonyl-CoA-sensitive enzyme was solubilized with octyl glucopyranoside in the presence of KCl. Significant enzyme activity, [2-14C]malonyl-CoA binding and malonyl-CoA inhibition of this enzyme was present only after removal of detergent by precipitation with poly(ethylene glycol). The enzyme activity was rapidly lost in the solubilized form. High concentrations of glycerol protected the enzyme. The alkylating irreversible inhibitor, S-(4-bromo-2,3-dioxobutyl)-CoA, strongly inhibited the malonyl-CoA-sensitive enzyme in the membrane residues. The enzyme was protected against this inhibitor by malonyl-CoA and palmitoyl-CoA. The more loosely membrane-bound malonyl-CoA-insensitive enzyme failed to bind malonyl-CoA, was stable in the presence of detergents and was not inhibited by S-(4-bromo-2,3-dioxobutyl)-CoA. It is suggested that two different carnitine palmitoyltransferase proteins exist in the inner mitochondrial membrane and that the detergent-labile malonyl-CoA-sensitive enzyme is the less easily extracted of the two.

Acyl Coenzyme A↗

Immunoregulatory lymphokines in rheumatoid joints. I. Search for interleukin 2 in synovial fluid.

Since there have been conflicting findings about the presence of interleukin 2 (IL-2) in synovial fluid (SF) of patients with rheumatoid arthritis (RA), we decided to study this subject ourselves. In a sensitive assay utilizing CTLL-2 as indicator cells, no IL-2-like activity was found in SF from any of the 15 RA patients studied. Treatment of SF with hyaluronidase, dialysation, heating to 56 degrees C for 1 h, preincubation of CTLL-2 with SF prior to washing and incubation all resulted in no detection of any IL-2. SF itself did not inhibit the CTLL-2 assay. Failure to detect IL-2 may to some extent be explained by in vivo absorption of any IL-2 by IL-2 receptor-positive T cells in SF. The failure is discussed along with new evidence from various reports suggesting that impaired IL-2 production by activated T cells may be a feature of several autoimmune diseases.

Arthritis, Rheumatoid↗

Serum profiles and short-term metabolic effect of pituitary and authentic biosynthetic human growth hormone in man. A double-blind cross-over study.

In a double-blind cross-over study we compared pituitary and methionine-free biosynthetic human growth hormone (P-hGH and B-hGH) with respect to pharmacokinetics and short-term metabolic effects in 9 hypopituitary children. They treated themselves for 4 weeks with 2 IU sc daily at 20.00 h. After admittance to hospital 2 IU was given: im the first day, and sc the second. They then switched over to the alternative preparation. The serum profiles of B- and P-hGH were identical. Comparing im and sc absorption, the latter was slower and resulted in smaller areas under the curves, indicating greater local degradation. Both preparations caused identical increases in somatomedin-C, but slightly more sustained after sc injection. Plasma glucose, plasma glucagon, and serum insulin fluctuated within normal ranges. The glucose profile pointed at a modest anti-insulin effect of hGH when given in the morning. The concentration in the blood of lactate, alanine, glycerol and B-OH-butyrate, and in serum of triglyceride, cholesterol and carbamide revealed no abnormalities with either hGH preparation. Finally, no development of anti-GH or E. coli polypeptide antibodies was seen. In conclusion, the pharmacokinetics and short-term metabolic effects of B-hGH and P-hGH were identical.

Adolescent↗

Carnitine palmitoyltransferase: separation of enzyme activity and malonyl-CoA binding in rat liver mitochondria.

Carnitine palmitoyltransferase activity and malonyl-CoA binding capacity have been studied in Triton X-100 extracts and membrane residues of rat liver mitochondria. Rat liver mitochondria extracted twice with 0.5% Triton X-100 in a salt-free medium showed increased specific binding of [2-14C]malonyl-CoA when compared with intact mitochondria. High malonyl-CoA binding required the presence of salts and was inhibited by albumin. Further solubilization of the membrane residues in the Triton/KCl medium and subsequent hydroxylapatite chromatography gave a complete separation of carnitine palmitoyltransferase and malonyl-CoA binding. The results show that malonyl-CoA binds to mitochondrial component(s) which is different from and more difficult to extract from the mitochondrial membrane than most of the carnitine palmitoyltransferase.

Acyl Coenzyme A↗