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Biomedical subjects

I Eriksson

Publications and source records attributed to I Eriksson.

At least 55 records · Page 3Linked to original sources

Expression of a new set of glycolytic isozymes in activated human peripheral lymphocytes.

The combination of phorbol 12-myristate 13-acetate (PMA) and concanavalin A induces the expression of a new set of glycolytic isozymes in human peripheral lymphocytes. The induced isozyme for each enzyme tested (hexokinase, phosphofructokinase, enolase, pyruvate kinase and lactate dehydrogenase) is usually the muscle form, which is often associated with rapidly dividing tumor cells. Increases in a specific isozyme can account for the 2-5-fold increase in specific activities of the enzyme induced by Con A plus PMA. Increased specific activities and the appearance of the new isozyme forms both occur relatively late, and are probably associated with the G1 or S phase of the cell cycle.

Cells, Cultured↗

A new method of angiographic runoff evaluation in femorodistal reconstructions. Significant correlation with early graft patency.

In 62 patients undergoing femorodistal bypass surgery, the foot vessel runoff was analyzed with a new grading system based on intraoperative postreconstruction serial angiography. The patients were divided into two groups according to the level of the distal anastomosis (proximal or low). Good runoff was defined as integrity of the anterior and/or posterior foot arch in proximal femorodistal grafts and integrity of both arches in low bypasses. In the proximal group, runoff was classified as poor when the arches were deficient or occluded, and in the low group, when only one arch was intact. The patency rate after 6 months was 81% in the good runoff group, whereas all grafts in patients with poor runoff were occluded. The new method allowed better prediction of the early outcome than does the primary and secondary pedal arch integrity concept.

Aged↗

CSF beta-endorphins in childhood neuropsychiatric disorders.

Thirty-one children with autistic disorder, 8 with the Rett syndrome (RS), 2 with childhood disintegrative disorder and 5 with infantile spasms were compared with healthy adult controls with respect to cerebrospinal fluid (CSF) beta-endorphin levels. The autistic disorder and RS groups showed significantly lower values than the other groups. There were no age trends within the various groups. Further study of CSF beta-endorphins in these disorders and blindly examined age matched controls is warranted.

Adolescent↗

Prevention of myocardial infarction and stroke in patients with intermittent claudication; effects of ticlopidine. Results from STIMS, the Swedish Ticlopidine Multicentre Study.

The Swedish Ticlopidine Multicentre Study (STIMS) was a double-blind placebo-controlled trial designed to determine whether ticlopidine, a platelet antiaggregatory agent, reduces the incidence of myocardial infarction, stroke and transitory ischaemic attacks in patients with intermittent claudication. A total of 687 patients was monitored for a minimum of 5 years or until an end-point was reached. The number of end points (99 vs. 89), analysed according to the intention-to-treat principle, was 11.4% lower in the ticlopidine group (P = 0.24). The mortality rate was 29.1% lower in the ticlopidine group (64 vs. 89, P = 0.015); this observation could be accounted for by a reduced mortality from ischaemic heart disease. On-treatment analysis showed there to be significantly fewer end points in the ticlopidine group (47 vs. 76, P = 0.017). Diarrhoea was the most common side-effect. Reversible leucopenia or thrombocytopenia was reported in seven patients on ticlopidine. It is concluded that the high morbidity and mortality from cardio- and cerebrovascular disease in patients with intermittent claudication can be reduced by long-term treatment with ticlopidine.

Aged↗

Valvular incompetence in superficial, deep and perforator veins of limbs with varicose veins.

Venous valvular incompetence was investigated with Doppler technique in 296 limbs with untreated primary varicose veins. Partial or complete insufficiency of the long saphenous vein was found in 95%. Six patterns of incompetence of this vein could be distinguished. Insufficiency of the short saphenous vein was present in 15% of the limbs and perforator incompetence in 45%. Femoral and/or popliteal vein reflux was found in 20% of the limbs. In eight limbs (2.7%) with verified primary deep venous insufficiency there was a moderate or severe degree of femoral and popliteal venous reflux. Skin changes secondary to the venous disease were present in 18% of the limbs, mainly those with incompetence of perforator and long saphenous veins. Doppler investigation of varicose limbs give valuable information and can be recommended as a standard pre-treatment test.

Adolescent↗

Phlebographic evaluation of nonthrombotic deep venous incompetence: new anatomic and functional aspects.

The anatomy, valvular function, and reflux patterns in the deep veins of the lower extremities were studied by ascending and descending phlebography in 126 limbs with nonthrombotic deep venous incompetence. The most common patterns were isolated reflux in the superficial femoral vein (51%), and combined reflux in the superficial femoral and the deep femoral veins (44%). Isolated deep femoral vein reflux occurred in 5%. As the degree of reflux in this vein varied considerably, a grading system for classification of deep femoral vein reflux was proposed. Depending on variations in the deep femoral vein anatomy, four different patterns could be distinguished. This study demonstrated that contrast filling of the deep femoral vein during ascending phlebography may indicate the presence of reflux in this vein. Complete visualization of the deep femoral vein is a new diagnostic sign that strongly correlates (p less than 0.001) with reflux in the deep femoral vein. The mean number of valves in the superficial femoral vein was reduced with increasing degree of reflux compared with a reference group consisting of 41 extremities without reflux. The diameter of the popliteal vein was significantly increased in the presence of pathologic reflux, which may indicate that vein wall dilation is a major cause of primary nonthrombotic deep venous incompetence.

Female↗

Angiographic criteria for prediction of early graft failure of secondary infrainguinal bypass surgery.

Complete intraoperative postreconstruction angiograms were obtained during 93 reoperations after failed femoropopliteal and femorodistal bypass grafts to evaluate the predictive value of a new method of angiographic runoff assessment. Good runoff was defined as patency of two or three lower leg arteries to the foot, or one patent vessel continuous with an intact anterior or posterior foot arch in femoropopliteal and proximal femorodistal bypasses, and integrity of both arches in low femorodistal bypasses. All other outflow patterns were considered poor. The cumulative 1-year patency rate was 61% with a 79% limb salvage rate after reoperations performed in limbs with good runoff. In reoperations with poor runoff, the patency rate was only 5% with a 22% limb salvage rate. In reoperations with good runoff, and 85% patency rate of vein grafts compared to 43% of prosthetic grafts clearly demonstrated the importance of graft material on early outcome. The improved prediction of early outcome with this new method of angiographic runoff evaluation might allow more rational management of patients with failed infrainguinal grafts.

Adult↗

Evaluation of extracorporeal shock wave lithotripsy without anesthesia using a Dornier HM3 lithotriptor without technical modifications.

In 210 patients with urolithiasis extracorporeal shock wave lithotripsy was performed without regional, general or infiltration anesthesia by means of a technically unmodified Dornier HM3 lithotriptor. The stone burden varied from small ureteral stones to complete staghorn stones. All patients were given premedication with pethidine and diazepam, and a lidocaine-prilocaine-containing cream was applied on the skin at the entry site of the shock wave. Energy usually varied between 14 and 16 kv. More than 90% of the patients reported the pain to be at most of moderate intensity and acceptable. Less than 3% found the treatment unpleasant. The results were compared to those obtained in 250 patients treated with anesthesia according to the original procedure, with a generator voltage of 18 to 23 kv. The number of extracorporeal shock wave lithotripsy sessions for ureteral and large stones was somewhat higher with the low energy method than with the original procedure. However, the therapeutic result in terms of renal units without stones after 4 weeks was similar to that recorded for patients treated with the anesthesia method. According to these promising results we believe that extracorporeal shock wave lithotripsy without anesthesia in an unmodified Dornier HM3 lithotriptor can be performed successfully in a majority of patients and is an attractive alternative to other technical modifications of the equipment.

Anesthesia↗

Arterial lesions of the foot vessels in diabetic and non-diabetic patients undergoing lower limb revascularisation.

This study was undertaken to compare the atherosclerotic involvement of the foot arteries in diabetic and non-diabetic patients with leg ischaemia. Ninety-four non-diabetic and 57 diabetic patients were investigated with intraoperative postreconstruction serial angiography during femoro-popliteal and femoro-distal bypass surgery. The foot vessels were evaluated with regard to the anterior and posterior foot arches which were classified as intact, deficient or occluded. Integrity of the pedal circulation was defined as patency of both the anterior and posterior foot arches. Severe involvement of the foot arches was rarely seen in limbs with 3- or 2-lower leg vessel run-off to the foot. The posterior foot arch was more often spared than the anterior foot arch, especially in the non-diabetic group (P less than 0.001). The integrity of the pedal circulation was similar in diabetic and non-diabetic patients (intact in about 20%). Patients with claudication showed a significantly lower occlusion rate of leg and foot arteries than patients with rest pain or gangrene. The results of this study showed that the foot vessels were similarly affected in diabetics and non-diabetics undergoing lower limb revascularization. The same aggressive diagnostic and therapeutic approach should be applied for limb salvage in both groups.

Aged↗

Evaluation of a disk approximation test of inducible beta-lactamases in Enterobacteriacae and Pseudomonas aeruginosa.

A modified disk approximation test of inducible beta-lactamases in Enterobacteriacae and Pseudomonas aeruginosa was evaluated. The amount of inducer was adapted to produce the smallest possible zone of inhibition and the distance between the centre of the disks was standardized. Among several beta-lactam antibiotic disks tested, imipenem (0.06 microgram per disk) or cefoxitin (10 micrograms per disk) placed at a distance of 14-16 mm from a cefotaxime disk (30 micrograms) most efficiently revealed inducible beta-lactamases. A positive induction test (primarily expected with Enterobacter spp, Citrobacter freundii, Serratia spp, Pseudomonas aeruginosa and indole positive Proteus spp) may serve as a warning of the risk of selecting mutants with beta-lactamase mediated cross-resistance during systemic treatment with ureidopenicillins, later generations of cephalosporins or monobactams. Such resistance was exemplified by characterization of some laboratory mutants with hyperproduction of beta-lactamases. However, evaluation of the specificity and sensitivity of the disk approximation test (and other indirect induction tests) still remains to be done.

Enterobacteriaceae↗

Primary deep venous incompetence in limbs with varicose veins.

Deep venous valvular incompetence (DVI) of primary, non-thrombotic origin has received little interest compared with secondary, postthrombotic DVI. In this study both limbs of 308 patients with untreated or surgically treated varicose veins in at least one limb were examined with Doppler ultrasound for signs of deep vein reflux. Ascending venography was used to exclude limbs with secondary DVI and descending venography to assess valve function. Doppler examination disclosed reflux in 3.5% of the "normal" limbs but in none of the limbs without recurrent varicose veins. A high incidence of primary DVI was found in limbs with untreated varicose veins (20.6%, p less than 0.001) and in those with recurrent or residual varicose veins (42.9%, p less than 0.001), compared with that in "normal" limbs. Popliteal vein reflux was observed in 14% and 37% in these two groups and a combination of femoral and popliteal reflux in 4% and 16%. Reflux of grade 2 or more at descending venography was noted in 43 of 78 limbs with Doppler evidence of reflux. Primary DVI is a common condition in patients with varicose veins. Further studies are needed to determine its clinical significance.

Adolescent↗

Postoperative predictive value of a new method of intraoperative angiographic assessment of runoff in femoropopliteal bypass grafting.

In 96 consecutive patients undergoing primary femoropopliteal bypass grafting, the runoff was evaluated with a new grading system, based on findings at intraoperative postreconstruction serial angiography. This concept, which takes foot vessel involvement into account in patients with only one patent crural artery, is a modification of the traditional method of runoff assessment. Good runoff was defined as patency of two or three lower leg arteries to the foot or one patent, vessel continuous with intact anterior or posterior foot arch. In limbs with no patent vessel or one patent vessel with deficient or occluded foot arches, the runoff was classified as poor. The cumulative primary patency rates at 12 months in groups with good and poor runoff were 81% and 37%, respectively. The predictive value of the new method was superior to that of other comparable methods (traditional method, Society for Vascular Surgery and International Society for Cardiovascular Surgery criteria, and modified Society for Vascular Surgery and International Society for Cardiovascular Surgery criteria). This improved prediction can be ascribed to the optimal angiographic technique for visualizing distal vessels, selective evaluation of foot vessel runoff with a new concept, and the criteria used to define good and poor runoff.

Adult↗

Angiographic runoff patterns in patients undergoing lower limb revascularization.

Intraoperative postreconstruction serial angiography was performed in 194 patients undergoing lower-limb revascularization (206 limbs), in order to analyze the atherosclerotic involvement of the lower leg and foot arteries. Occlusion of two or three leg vessels was found in 71% of the diabetic patients, and in 52% of the non-diabetics. The peroneal artery was less frequently affected than the other leg arteries. Severe involvement of the foot arteries was commonly observed in patients with only one or no patent leg vessel. The posterior foot arch was less commonly affected than the anterior. Complete visualization of the lower leg and foot arteries is suggested to be important for adequate evaluation of the distal vascular runoff. Pedal runoff may have prognostic significance in femoropopliteal as well as femorodistal bypass surgery.

Adult↗

Endogenous opioids in cerebrospinal fluid of opioid-dependent humans.

Endogenous opioid systems may be altered as a consequence of addiction, but evidence to support this idea is meager so far. We obtained 136 cerebrospinal fluid (CSF) samples from 72 opioid addicts during four distinct states: methadone maintenance, detoxification from methadone, opioid antagonist treatment, and drug-free status. CSF endorphins were measured in 86 patients samples using a radioreceptor assay (RRA), and beta-endorphin levels were measured in 85 patient samples using a radioimmuno assay (RIA). During detoxification, both RRA fraction I and beta-endorphin showed a generally similar pattern of changes. Both were lowest when measured 40-50 hr after the last opioid dose, and both showed an apparent rebound to higher than methadone maintenance values at 60-70 hr following the last dose. During methadone maintenance and drug-free states, the addicts' levels of fraction I RRA endorphins in the CSF were higher than levels found in a normal control group. Fraction II endorphins were also elevated in the addicts who were drug free. In contrast, CSF beta-endorphin during both methadone maintenance and drug-free states was lower in the addicts as compared to the normal, drug-naive group. Except for the pattern found during detoxification, there were no consistent changes in endorphin levels across different states of addiction.

Adult↗