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Biomedical subjects

J Larsson

Publications and source records attributed to J Larsson.

281 records · Page 16Linked to original sources
PubMedDate not supplied

Rapid determination of cold insoluble globulin by laser nephelometry. Application in patients receiving preoperative total parenteral nutrition.

A simple and rapid method for determining plasma fibronectin or cold insoluble globulin (CIG) based on immunochemical precipitation and laser nephelometry is described. The coefficient of variation within the series was 4.2% and between the series 9.1%. The mean value for 37 control subjects was 100.1% +/- 20.6 (SD). Nineteen patients with gastrointestinal carcinoma or Crohn's disease were investigated on admission. The mean value of their plasma CIG was 104.7 +/- 26.9 (SD), which was not statistically different from the control subjects. Twelve of the patients received total parenteral nutrition (TPN) during the two preoperative weeks. The concentration of CIG was significantly increased after one and two weeks of TPN compared to the initial value. Six out of seven patients that postoperatively showed signs of infection had CIG values below 90% on admission. Of several other plasma proteins determined on admission, only a statistically significantly negative relationship to transferrin was found. CIG did not significantly relate either to the acute phase reactants, haptoglobin and orosomucoid, or to visceral proteins albumin, choline esterase or prealbumin.

Adult↗
PubMedDate not supplied

Influence of total parenteral nutrition on plasma fibronectin in malnourished subjects with or without inflammatory response.

Plasma fibronectin, which is an alpha 2-glycoprotein of importance for the immunodefence, has been reported to decrease after starvation and in severely ill patients with cancer. To evaluate the usefulness of fibronectin as an indicator of nutritional repletion, 18 patients with gastrointestinal disorders were studied over a 2-wk period of total parenteral nutrition (TPN). According to nutritional assessment on admission the patients were divided into well nourished (n = 6) and malnourished (n = 12). For comparison nine patients with anorexia nervosa were also studied over a 3-wk period of TPN. Before and after TPN fibronectin, albumin, prealbumin, transferrin, and two acute-phase reactants, haptoglobin and orosomucoid were measured in plasma. The majority of the malnourished patients had an inflammatory reaction in contrast to only a few of the well-nourished and anorexia nervosa patients. Of the proteins measured, only fibronectin rose significantly in the malnourished patients (malnourished and anorexia nervosa), but not in the well nourished patients during TPN. Our results may indicate the usefulness of fibronectin as an indicator of short-term TPN in malnourished subjects, irrespective of the presence or absence of inflammatory response.

Adolescent↗
PubMedDate not supplied

Skeletal muscle function and metabolism in obese women.

A possible mechanism to regulate body weight during a high calorie intake may be an increased metabolic rate in skeletal muscle. To approach this hypothesis the energy metabolites, ATP, phosphocreatine, creatine, glycogen and lactate were measured in biopsies from the quadriceps femoris muscle. Concomitantly the function of the adductor pollicis muscle was studied as assessed after electrical stimulation of the ulnar nerve. The muscle function variables were, force of contraction at 5, 10, 20, and 50 Hz of stimulation, relaxation rate, and endurance. Eight obese women were studied before gastroplastic surgery and 6 months postoperatively and a weight loss of 19.4 +/- 3.4% (mean +/- SEM). Preoperatively ATP, phosphocreatine, glycogen, and lactate were significantly decreased and the same pattern was found postoperatively. These findings can be related to a low production of energy-rich phosphates or a high energy utilization. Both pre- and postoperatively there was, a decreased force of contraction at 10 Hz of stimulation (p less than 0.001), a faster relaxation rate (p less than 0.01) and a normal endurance. These functional results indicate a high metabolic rate. At admission a decreased serum insulin level indicated a moderate insulin resistance which was normalized after the weight loss. The triiodothyronine concentration was normal before and after operation. In conclusion our findings of changed muscle energy metabolite concentrations and altered muscle function indicate a high metabolic rate in skeletal muscle in obese women. This may be an adaptation in skeletal muscle energy metabolism to a high body weight.

Adult↗
PubMedDate not supplied

Whole-protein-based enteral formula stimulates intestinal ornithine decarboxylase activity more than single amino acids but does not affect mucosal adenosine triphosphate content in early postsurgical refeeding.

BACKGROUND: To restore intestinal integrity after starvation and trauma, luminal nutrients are essential. Specific nutrients such as glutamine support mucosal proliferation and energy metabolism. The aim of this study was to compare effects of enteral formula vs specific amino acids on ornithine decarboxylase (ODC) activity and adenine nucleotide metabolism in jejunal mucosa. METHODS: Male Wistar rats (240 to 280 g) were starved for 48 hours and subjected to intestinal transection, gastrotomy, and jejunal instillation of 5mL nutrient solution. In the first experiment, standard enteral formula (EF) was compared with isonitrogenous formula supplemented with the glutamine precursor, alpha-ketoglutarate (alpha-KG). In a second experiment, 2% glutamine was compared with isonitrogenous ornithine alpha-KG, arginine alpha-KG, glycine and diluted standard enteral formula (EF), or saline. The ODC activity, adenosine triphosphates (ATP), and RNA and protein in the jejunal mucosa were analyzed 2 hours after surgery. RESULTS: The ODC peak in jejunal mucosa in animals treated with EF was higher than when supplemented with alpha-KG (p < .05). Compared with specific amino compounds, EF resulted in a significantly higher ODC peak and no differences were seen between the different specific amino acids. Differences seen in ATP or energy charge between the groups were not significant. CONCLUSIONS: Immediate postoperative enteral feeding by standard EF results in rapid increase of ODC activity. This response was attenuated when the enteral nutrition was supplemented with alpha-KG and was absent when isonitrogenous single amino acids were administered. We found no significant effects on ATP content in the small bowel mucosa by supplementing the diet with alpha-KG.

Adenosine Triphosphate↗
PubMedDate not supplied

Ketanserin in the treatment of diabetic foot ulcer with severe peripheral vascular disease.

The aim of this study was to evaluate if ketanserin, a selective serotoninantagonist, could improve wound healing in diabetic patients with foot ulcers and severe peripheral vascular disease. In a double blind study 40 diabetic patients with foot ulcer and a systolic toe pressure below 45 mmHg were randomly allocated to either ketanserin (20-40 mg three times a day) or placebo for a period of 3 months. The treatment was carried out on an out-patient basis by a combined medical/orthopedic foot care team at the Department of Internal Medicine, University Hospital, Lund, Sweden. Both groups were comparable regarding age, sex, duration and treatment of diabetes, cardiovascular disease and type of lesion. Wound healing (defined as intact skin for at least 3 months) or wound size reduction of 50% or more were sen in 11 out of 19 (58%) in the ketanserin group and in 7 out of 19 (37%) in the placebo group. Gangrene developed in 6 patients with placebo and 2 with ketanserin. Two patients died during the study and their ulcers were not evaluated. The systolic toe pressure was measured at admission, at end of run in, after 1 month and 3 months with strain gauge technique. Only one out of nine patients (11%) with a toe pressure below 30 mmHg in the placebo group healed or improved their ulcers compared to nine out of 16 (56%) in the ketanserin group. The healing rate in the ketanserin group was higher than expected considering the lower systolic toe pressure in this group compared to placebo at randomization (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMedDate not supplied

Effect of buflomedil on cell metabolism in ischemic muscle.

The effect of Buflomedil on cell metabolism in ischemic muscle was studied in pigs. Six pigs received Buflomedil 6 mg per kg intravenously 30 minutes prior to induction of total leg ischemia, whereas 6 control animals were not premedicated. Arterial and venous blood samples and muscle specimens from the ischemic leg were collected prior to ischemia, after 5 hours of ischemia, and after 10 minutes and 30 minutes of reperfusion of the leg, and analysed for metabolic parameters. Similar decreases in local venous pH and PO2 indicated comparable and severe leg ischemia in both groups. Similar increases in venous and arterial concentrations of potassium and creatine kinase indicated a comparable degree of cell damage in the two groups. The ischemic muscle specimens in the Buflomedil group contained significantly higher phosphocreatine (PC) levels (p less than 0.01) and significantly lower lactate levels (p less than 0.01) than did the control group, whereas ATP levels were comparable in the two groups. We conclude that Buflomedil reduces PC-conversion, glucolytic activity and energy demands of the ischemic cell.

Adenosine Triphosphate↗
PubMedDate not supplied

The relation between nutritional state and quality of life in surgical patients.

OBJECTIVE: To explore the relationship between nutritional status and quality of life in a group of patients in a surgical department. DESIGN: Prospective open study. SETTINGS: Department of Surgery, University Hospital, Linköping, Sweden. SUBJECTS: The patients (n = 199) included 89 females and 110 males, mean age 59 years. INTERVENTIONS: The nutritional status was assessed by the percentage weight loss (% WL), weight index (WI), arm muscle circumference (AMC), triceps skin fold thickness (TSF), serum-albumin (Alb) and serum-prealbumin (p-Alb) concentration. Malnutrition was classified as three or more abnormal values and the overall frequency was 35%. The quality of life was assessed by a self-administered rating form with a life-domain rating part and a well-being rating part. In the current statistical analysis, the nutritional status and its different nutritional markers were tested for significant associations with the life-domain ratings (n = 7) and wellbeing scales (n = 11). RESULTS: There were significant relations between malnutrition according to nutritional assessment (p < 0.001), % WL (p < 0.005-0.001), Alb (p < 0.05-0.001), p-Alb (p < 0.01-0.001) and quality of life in all life domains except for the social network sphere. The anthropometric variables AMC and TSF showed no association with life domain ratings. As to the wellbeing ratings, an even stronger and more consistent relation were seen between a malnourished state (p < 0.01-0.001), % WL (p < 0.01-0.001), WI (p < 0.01-0.001), Alb (p < 0.01-0.001) and p-Alb (p < 0.05-0.001). AMC and TSF were not linked to the wellbeing ratings. CONCLUSIONS: In summary, there was a close association between malnutrition and impaired quality of life.

Adult↗