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Biomedical subjects

H Olivecrona

Publications and source records attributed to H Olivecrona.

At least 37 records · Page 2Linked to original sources

Importance of growth hormone for the induction of hepatic low density lipoprotein receptors.

This investigation was undertaken to determine the possible role of growth hormone (GH) in the hormonal regulation of hepatic low density lipoprotein (LDL) receptor expression. Treatment of normal rats with estrogen (ethynylestradiol, 5 mg/kg per day) increased the number of hepatic LDL receptors, and the LDL receptor mRNA levels were increased 2.4-fold. However, when hypophysectomized rats were treated with estrogen, the hepatic LDL receptor number and the mRNA levels only increased slightly. Treatment with GH was important to restore the induction of hepatic LDL receptors in hypophysectomized estrogen-treated rats. Further, the hypocholesterolemic effect of estrogen was abolished in hypophysectomized rats, and GH reversed this effect. To assess the effect of GH in humans, hepatic LDL receptor binding activity was determined in liver biopsy specimens from gallstone patients pretreated with GH (12 international units/day) prior to operation. GH administration induced hepatic LDL receptors approximately 2-fold, and this was accompanied by a 25% decrease in serum cholesterol. The LDL receptor stimulation caused by GH treatment was of similar magnitude as that observed upon 3 weeks of treatment with an established hypolipidemic drug (pravastatin or simvastatin). The data show that GH has an important role in the regulation of hepatic LDL receptors and suggest that GH secretion may be important for the control of plasma LDL levels in humans.

Adult↗

Hepatic cholesterol metabolism in estrogen-treated men.

Operative liver biopsies were obtained from two male patients who developed gallstone disease during estrogen treatment of metastatic prostatic carcinoma. The heparin-sensitive binding of 125I-low-density lipoprotein (LDL) to liver homogenates (reflecting the expression of the LDL receptor) was determined, together with the activities of the rate-limiting enzymes in cholesterol synthesis [3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase], bile acid production (cholesterol 7 alpha-hydroxylase), and cholesterol esterification (acyl CoA:cholesterol acyl transferase). The results were related to data available in 18 patients (5 male, 13 female) who underwent cholecystectomy because of gallstone disease. The hepatic 125I-LDL-binding activity was increased threefold compared with five controls, and the activity of HMG-CoA reductase was increased twofold. There was no major difference in the activities of cholesterol 7 alpha-hydroxylase or acyl CoA:cholesterol acyl transferase. The concentration of free and total cholesterol in liver microsomes was approximately 30% lower in the estrogen-treated men than in 11 controls. The results indicate that estrogen at pharmacological doses stimulates hepatic LDL-receptor expression and HMG-CoA reductase activity in men. The increased LDL-receptor expression could in part explain the enhanced plasma clearance of injected 125I-LDL and hence the reduction in plasma LDL cholesterol previously shown to occur in estrogen-treated men.

Aged↗

Effects of growth hormone on low-density lipoprotein metabolism.

GH appears to play an important role in mediating the increase in hepatic LDL receptor expression that occurs in response to pharmacological oestrogen treatment. Furthermore, in normal individuals there is evidence of an increased number of hepatic LDL receptors in response to GH, resulting in an accelerated elimination rate of the LDL particle and a subsequent lowering of LDL cholesterol. Further studies on lipoprotein metabolism in patients with GH deficiency, and also in patients with hypercholesterolaemia, would therefore be of interest.

Biological Transport, Active↗

Cerebral arteriovenous malformation and cluster-like headache.

Cluster headache is considered a clinically distinct entity with no underlying gross pathology. However, in rare cases this kind of headache may be mimicked by an arteriovenous malformation. A 49-year-old male is described who had severe bouts of unilateral headache resembling those of cluster headache. The usual accompanying autonomic manifestations were minor and the headache attacks were prolonged. Treatment with ergotamine tartrate and pizotifen failed. A large ipsilateral arteriovenous malformation was diagnosed. Prospectively, true clustering of the headache attacks could not be documented.

Cerebral Angiography↗

The hollow skull: a sign of brain death in Tc-99m HM-PAO brain scintigraphy.

The advantage of Tc-99m HM-PAO, a newly introduced compound for brain perfusion imaging, is illustrated in three patients with suspicion of brain death. With Tc-99m HM-PAO, the carotid flow study is not essential, as it is in the Tc-99m pertechnetate carotid angiogram; planar images are equally useful; and there is no need for SPECT images. For the diagnosis of brain death, Tc-99m HM-PAO can be injected in the intensive care unit and planar images can be obtained at a later time using a mobile camera or whenever the patient can be moved to the nuclear medicine department.

Adolescent↗

Long-term results after carotid artery surgery.

This study presents the results from a follow-up after 414 carotid reconstructions performed on 352 patients during the years 1971-82. At the end of the follow-up period 267 patients were alive (75.8%) and 253 patients remained asymptomatic. The median follow-up time was 35 months (6 months-12 years). Patients with coronary artery disease (CAD) had a significantly lower survival than patients without signs of CAD. Coronary artery disease was significantly more frequent among patients with bilateral carotid lesions compared to patients with unilateral lesions. The actuarial stroke frequency, operative morbidity included, on the operated side was 2.5%/year. However, from 6 months postoperatively up to 8 years the stroke frequency was 1%/year. In the stroke frequencies all neurological deficits of more than 24 h duration are accounted for. Although there was a trend toward higher stroke rates among older patients there were no significant differences between age groups. Assuming a 10% stroke frequency during the first year after a TIA and a 6% annual stroke rate thereafter our results would cross even such a natural course curve at 18 months.

Actuarial Analysis↗

Risk factors in carotid artery surgery: an evaluation of 414 operations.

Four hundred and fourteen carotid reconstructions performed on 352 patients during the years 1971-82 were analysed retrospectively. Fifty-eight percent of the patients were operated on because of hemispheric transient ischaemic attacks (TIA). Twenty-eight percent had suffered a stroke before surgery. The overall combined mortality and morbidity was 7.7%. The procedure mortality was 2.9% with a slightly higher mortality i.e. 5.9% in the stroke group although not significantly higher than among non-stroke patients with a mortality of 1.4%. Patients of more than 70-years had a significantly higher operative mortality (11.1%) than the rest of the patients (1.7%). Non-fatal strokes occurred in 20 patients (4.8%). No correlation was found with the degree of stenosis of the contralateral artery.

Adult↗

Transient expression of insulin-like growth factor I immunoreactivity in skeletal muscle cells during postnatal development in the rat.

The immunohistochemical expression of insulin-like growth factor I (IGF-I; somatomedin C) was investigated in hindlimb skeletal muscle of rats during postnatal development. IGF-I immunoreactivity could be demonstrated in satellite fibres and myotubes 1, 2 and 3 days after birth, while no IGF-I immunoreactivity could be demonstrated in the more mature primary fibres. Five days after birth only scattered cells showed IGF-I immunoreactivity and 10 days after birth no specific IGF-I immunoreactivity could be demonstrated in muscle cells, i.e. the adult pattern was established. It is concluded that IGF-I immunoreactivity is expressed during a limited period of postnatal skeletal muscle maturation in rats. IGF-I is probably synthesized by IGF-I immunoreactive muscle cells and contributes to the differentiation/maturation process by autocrine and/or paracrine mechanisms.

Age Factors↗

Computed tomography and psychometric test performances in patients with solvent induced chronic toxic encephalopathy and healthy controls.

Patients with chronic toxic encephalopathy caused by occupational exposure to organic solvents and diagnosed between 1976 and 1981 have been re-examined during a follow up period of 21-88 months (median 48). Thirty two patients underwent computed brain tomography (CT), were retested psychometrically, and the results were compared with a group of age matched control subjects from the same socioeconomic level. The age of the patients was 33-69 (median 55) and they had been exposed to organic solvents for 7-50 years (median 26). The CT examinations were quantified by linear measurements on the films of the four largest sulci, the minimum width of the cella media and the third ventricle. Bifrontal horn, bicaudate, and third ventricle--Sylvian fissure distances were also measured; and measurements were adjusted for variation in skull diameter. No differences were found between the patients and controls. Most of the measures were correlated with age, to a somewhat higher degree in the patients. The patient-control differences did not increase with increasing age of the subjects. Psychometrically the patients performed worse than the controls despite adjustments for possible differences of intellectual level in the two groups. In the patients correlations were found between some of the CT measures and psychometric test performances suggesting slower psychomotor speed and attention difficulties among subjects with central and cortical brain substance reduction. No such correlation was found in the control group. It is concluded that patients with solvent induced chronic toxic encephalopathy have no severe loss of brain substance.

Adult↗

Spectral analysis with digital presentation of C-W Doppler signals in the evaluation of carotid stenosis.

Using a continuous-wave ultrasound Doppler system with spectral analysis (FFT) and digital processing and presentation, the Doppler shift characteristics of the carotid arteries were studied in 40 healthy subjects (20 men and 20 women; average age 69 years). The reference values, thus obtained, were applied to the analysis of sonograms from 46 carotid arteries, which were also studied angiographically. Stenoses which reduced the diameter of the internal carotid artery by more than 30% could be identified with a sensitivity of 97% and a specificity of 100%. The results extend previous experience that spectral analysis improves the usefulness of the ultrasound Doppler system in the evaluation of carotid artery disease. The addition of digital processing and presentation of the Doppler shift characteristics increases the diagnostic precision and provides a permanent record. The importance of well-trained sonographers and adequate reference values is emphasized.

Aged↗

Non-invasive detection of carotid bifurcation disease by continuous-wave Doppler with spectral analysis.

The diagnostic accuracy of 5 MHz continuous-wave (C-W) Doppler with spectral analysis for detecting carotid bifurcation disease was evaluated. In a first phase of the study, normal confidence intervals for peak frequency data and spectrum width were established and Doppler spectrum abnormalities were separated into three types (spectral broadening with preserved window, spectral broadening without window, sequence of abnormalities including inverted Doppler spectrum). In a second phase the diagnostic accuracy of these variables was tested on 86 carotid arteries as independently compared with angiography. Whereas both peak frequency data and spectrum distribution findings were invariably abnormal in stenoses greater than or equal to 60%, spectrum distribution findings were more accurate in 30-59% stenosis. Using spectrum distribution criteria, sensitivity and specificity for stenosis greater than or equal to 30% were 94.6% and 90.7% respectively. All variables were insensitive for stenoses less than 30% lumen diameter reduction.

Adult↗

Excitative effects in anaesthetized rabbits from subarachnoidally injected iso- and hyperosmolar solutions of iohexol and metrizamide.

Equimolar doses of iohexol and metrizamide (0.48 mmol/kg body weight = 185 mg I/kg), administered in solutions iso- and hyperosmolar to the CSF, were injected subarachnoidally into rabbits under pentobarbital anaesthesia. No excitative effects of iohexol were observed in the behaviour of the rabbits during a 3-h period immediately after the injection. Metrizamide caused significant, severe excitative effects, ranging from hyperexcitability to repeated generalized seizures. The frequency and severity of excitative effects were independent of the osmolality of the metrizamide solutions injected.

Anesthesia↗

Interaction between chlorpromazine and intrathecally injected non-ionic contrast media in non-anaesthetized rabbits.

During a 14-day period, 45 of 78 rabbits were treated intravenously with chlorpromazine (5 mg kg-1 day-1). Metrizamide or iohexol was injected subarachnoidally and the neurotoxic effects of each substance on rabbit behaviour were evaluated for 3 h in both chlorpromazine-treated and non-treated rabbits. Chlorpromazine increased both the excitative and the depressive effects of metrizamide and the depressive effects of iohexol. No signs of excitation were observed in chlorpromazine-treated and non-treated rabbits after subarachnoid injections of iohexol. In spite of a free flow of clear fluid from the needle both before and after the intended subarachnoid injection, radiography disclosed that 26 of 67 suboccipital injections inadvertently resulted in a subdural deposition of the contrast medium. Contrast medium effects following subdural injection significantly differed from those following subarachnoid injection.

Akathisia, Drug-Induced↗

Progressive bilateral thinning of the parietal bones.

Observation of a case of progressive bilateral parietal thinning within a period of 14 years induced us to study skull films of 3,636 consecutive patients. Parietal thinning was found in 86 patients (2.37%). It was more common in women, with a sex ratio of 1:1.9. The mean age of the females was 72 years, and that of the males 63 years. Previous skull films of 25 of these patients were available and showed progression in 10. It is concluded that parietal thinning is a slowly progressive disease of middle-aged and old patients and is not an anatomical variant or congenital dysplasia of the diploe.

Adult↗

Computed tomography and CSF spectrophotometry. Diagnosis and prognosis in 300 patients with cerebrovascular disease.

Computed tomography (CT) has been reported to show normal findings in 13-52% of patients with cerebrovascular diseases. Among factors deciding the diagnostic accuracy are the size and location of the lesion, the time elapsed from onset to examination, the use of contrast enhancement and the type of CT scanner used. To further elucidate these aspects, we designed the present study including 300 consecutive patients, all investigated by CT with a 160 x 160 matrix and cerebrospinal fluid spectrophotometry (CSF-SPE). CT indicated a specific diagnosis in 52.7%. In the majority of the remaining cases, additional subclassification was possible by CSF-SPE, emphasizing the complementary information obtained by combined examinations. CT was also found to be a useful tool for reliable prognostic prediction, irrespective of the initial clinical course.

Adolescent↗

Attenuation profiles of the petrous bone with acoustic neuroma.

Attenuation profiles across the petrous bone covering the whole internal auditory meatus (IAM) were constructed from the printouts obtained by computed tomography (CT) with narrow collimation performed on 12 patients with 13 acoustic neuromas. In healthy patients the attenuation profiles of right and left petrous bone were very similar in shape. The attenuation values of the individual pixels in the pixel columns of the printout located at the site of the porus and the IAM reflected the demineralization of the petrous bone and the widening of the porus and the IAM caused by the acoustic neuroma. A widening deep in the meatus was demonstrated in a patient with an intracanalicular tumor, and therefore it seems possible to make this diagnosis by CT scanning combined with the construction of attenuation profiles across the petrous bone. In the presence of unilateral acoustic neuroma there was a significant and characteristic difference in shape between the attenuation profiles of the two sides with generally lower attenuation values on the tumor side together with signs of widening of the porus and the IAM. In cases of bilateral acoustic neuroma comparison of the attenuation profiles can be made with mean attenuation curves obtained from scanning normal petrous bones. The prevailing physical limitations for demonstrating a narrow bony canal like the IAM with CT was experimentally analyzed using bone-simulating plastic material.

Humans↗