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Biomedical subjects

J Larsson

Publications and source records attributed to J Larsson.

At least 145 records · Page 8Linked to original sources
PubMed1993

Pancreatic cancer is associated with impaired glucose metabolism.

OBJECTIVE: To investigate glucose metabolism and insulin secretion on patients with pancreatic cancer compared with healthy control subjects. DESIGN: Open study. SETTING: Linköping University Hospital, Sweden. SUBJECTS: 44 consecutive patients referred for radical operations for pancreatic carcinoma, and eight healthy age and sex matched volunteers. INTERVENTIONS: Hyperglycaemic glucose clamp in 36 of patients and all volunteers. MAIN OUTCOME MEASURES: Glucose tolerance according to WHO criteria, plasma insulin and C-peptide concentrations, and insulin secretion measurements both during hyperglycaemia and after stimulation by glucagon. RESULTS: Thirty-three patients (75%) had either impaired glucose tolerance or diabetes. Fasting insulin concentrations were raised in the non-insulin-requiring diabetic patients, but similar in the insulin-requiring group compared with healthy control subjects and patients with normal glucose tolerance. In neither diabetic group was insulin secretion affected during hyperglycaemia. After stimulation with glucagon, insulin secretion increased in non-insulin-requiring diabetic patients but remained unchanged in those who required insulin. Glucose metabolic capacity and whole body insulin sensitivity were reduced in patients with diabetes and with impaired glucose tolerance, and the reduction was more pronounced in diabetic patients. CONCLUSIONS: There is a high incidence of impaired glucose tolerance and diabetes in patients with pancreatic cancer, which cannot be explained by impaired secretion of insulin. Other factors that reduce insulin sensitivity seem to have a role in the development of diabetes in this group of patients.

Adenocarcinoma↗
PubMed1992

Randomized, controlled study evaluating effects of branched chain amino acids and alpha-ketoisocaproate on protein metabolism after surgery.

The effect of nutritional supplementation with branched chain amino acids or the ketoacid alpha-ketoisocaproate on protein metabolism after surgery was studied in 24 patients with gastrointestinal cancer. They were randomized to receive one of three nutritional regimens. All patients received a balanced amino acid solution and group 1 (n = 8) received no further supplements, group 2 (n = 8) received supplementation with alpha-ketoisocaproate (17 g day-1) and group 3 (n = 8) received a branched chain solution including leucine, isoleucine and valine, corresponding to 3.3 g nitrogen day-1. Plasma albumin, prealbumin, fibronectin and serum urea concentrations, nitrogen balance and 3-methylhistidine release from the leg and its excretion in the urine were measured. Albumin and prealbumin concentrations fell after surgery in all groups, and fibronectin levels fell in group 2 (P less than 0.001). In group 2 there was also a significant increase in serum urea concentration after operation (P less than 0.05). Cumulative nitrogen balance after 3 days was -5.6 g (group 1), -3.8 g (group 2) and -1.7 g (group 3). The release of 3-methylhistidine (nmol 100 g-1 min-1) from the leg after operation, following an overnight fast, was -0.42 (group 1), -0.51 (group 2) and -0.66 (group 3). During infusion the release was -0.56, -0.99 and -0.81, respectively. A balanced amino acid solution with an adequate energy supply has an optimal nitrogen-sparing effect. Branched chain amino acids or alpha-ketoisocaproate did not improve nitrogen balance or reduce protein degradation.

Amino Acids, Branched-Chain↗
PubMed1992

Severity of disease and quality of life: a comparison in patients with cancer and benign disease.

The aim of our study was to compare the quality of life in patients with malignant and benign diseases. Eighty-nine females and 110 males (mean age 59 years) from the surgical unit at the University Hospital of Linköping were examined. Ninety-five subjects suffering from a gastrointestinal malignancy were compared with 104 non-malignant patients, of which 57 had benign gastrointestinal disorders, 24 endocrine and 23 vascular diseases. Quality of life was defined as perceived well-being and life satisfaction, globally as well as within key domains. Two separate types of self-ratings, a life domain (20 items) and a well-being rating (eleven subscales, each scale with ten items), were performed in the medical ward. The life domain rating covered the subject's own appraisal of his health and psychological circumstances; social network; activities and habits; of a structural domain ('ability to lead a meaningful life') and of his global life satisfaction. The well-being rating focused on emotional experiences (basic mood, security, indolence, loneliness, inferiority, and guilt together with future-orientation) and perceived behaviour (endurance, tension, sociability and attitudes of the environment). The patients who had a gastrointestinal malignancy scored consistently 'lower' than patients with benign diseases. After adjusting for age concerns, most of the significant inter-group differences remained. After adjusting for nutritional state influences (e.g., recent weight loss), differences in global life satisfaction, future-orientation and perceived attitude from the environment were still apparent. This study is contrary to several other studies undertaken in search of expected group differences but none were found.(ABSTRACT TRUNCATED AT 250 WORDS)

Evaluation Studies as Topic↗
PubMed1992

Effects of dietary supplement on functional condition and clinical outcome measured with a modified Norton scale.

Elderly long-term care patients (n = 501) were randomly allocated to receive dietary supplementation (400 kcal/day) in addition to a normal hospital diet, or normal hospital diet only, for 26 weeks. The patients' functional condition was assessed by a modified Norton scale comprising mental condition, activity, mobility, food intake, fluid intake, incontinence and general physical state. Nutritional status was assessed by anthropometry, serum protein analysis and delayed hypersensitivity skin tests. Improvements during the first 8 weeks were seen in activity and general physical condition in the supplemented group, and in mobility and general physical condition in the control group. After 8 weeks the supplemented group showed a significantly higher level of activity (p < 0.05) compared to the control group. We conclude that in long-term geriatric care nutritional supplements help to maintain and improve the patients function.

Journal Article↗
PubMed1992

The impact of leucine infusion on skeletal muscle amino acid and energy metabolism in severely traumatized patients.

The response to trauma is associated with increased energy requirements and net protein breakdown. The branched chain aminoacids, especially leucine, are considered to act by serving as a fuel for muscle tissue and by stimulating synthesis of proteins and controlling protein breakdown. Such results have been obtained mainly from in vitro studies. The present study was designed to evaluate the pharmacological effect of leucine infusion on muscle energy/amino acid metabolism in man after severe multiple trauma. 16 patients were studied and randomly allocated into 2 groups. Group 1 was given fat and 20% glucose while group 2 received 6 g N in form of leucine dissolved in 10% glucose solution and fat. The patients received 40 kcal/kg/24 h over an 8 day period after trauma. Biochemical analyses, muscle biopsies (energy substrates, electrolytes, amino acids), nitrogen balance and 3-methyl histidine excretion in urine were evaluated. Biochemical data revealed a significant increase (p < 0.05) of serum urea in group 2 day 4 and 8 after trauma. Muscle intracellular electrolytes (K(+), Mg(2+)) and energy substrates (ATP, phosphocreatine) showed a similar decrease in both groups. The intracellular muscle amino acids displayed a pattern known to be related to trauma without differences between the groups. The cumulative nitrogen balance 8 days after the injury was -93.5 g N +/- 10.1 (SEM) in group 1 and -73 g N +/- 7.5 in group 2. The 3-methylhistidine excretion was markedly increased similar in both groups. The present study demonstrated no significant pharmacological effect of leucine administration on muscle metabolism, nitrogen balance or 3-methylhistidine excretion in severely traumatized patients. Conventional balanced amino acid solutions are probably optimal to meet the patients actual requirements.

Journal Article↗
PubMed1992

Somatic and germline mutagenesis assayed by the unstable zeste-white test in Drosophila melanogaster.

This investigation is an attempt to compare mutation rates in germinal and somatic cells by the use of the unstable zeste-white assay in Drosophila melanogaster. In this system it is possible to use the same genetic end point to measure both somatic mutations (aberrantly pigmented spots in the eyes of adult flies) and germinal mutations (males with aberrantly pigmented eyes). We used two mutagens, formaldehyde and methylmethane sulphonate (MMS), to induce mutations and two different routes of mutagen administration, larval feeding and adult feeding, and scored mutations in somatic as well as germinal cells. Both types of tissues were susceptible to MMS mutagenesis, showing elevated frequencies of both germline mutations and eye spots. Formaldehyde, however, gave no increase in the germinal mutation rate but caused somatic mutations. These were found after larval exposure, but also among the offspring of exposed males, as formation of delayed somatic mutations. The results show that somatic cells are much more sensitive in monitoring induced mutations than germinal cells in this system. We also found that spontaneous mutation rate among germinal cells is 200 times higher than that in somatic cells, which presumably is due to the involvement of a mobile element.

Animals↗
PubMed1992

Muscle water and electrolytes in severe chronic congestive heart failure before and after treatment with enalapril.

To investigate the electrolyte and water content in peripheral skeletal muscle in patients suffering from severe chronic congestive heart failure, New York Heart Association functional class IV, and to study the influence of the angiotensin-converting enzyme inhibitor, enalapril, 22 patients were randomized in a double-blind study to receive either placebo (n = 11) or enalapril (n = 11) in addition to their conventional treatment. The patients included a subgroup in the previously published CONSENSUS study. At the beginning of the study, the content of potassium and magnesium was significantly reduced in muscle as compared with healthy subjects while sodium and water were increased. The muscle content was not predictable from the serum concentrations of the electrolytes. Following study treatment no significant changes occurred, neither within nor between the two subgroups. Thus, patients with severe chronic congestive heart failure, New York Heart Association functional class IV, displayed disturbed electrolyte and water content in muscle, which, in this study, was not corrected by treatment with enalapril.

Aged↗
PubMed1992

Muscle energy metabolism in severe chronic congestive heart failure--effect of treatment with enalapril.

By using biopsies, skeletal muscle metabolism was investigated in 22 patients with severe chronic heart failure. All the patients were in New York Heart Association functional class IV and constituted a subgroup of the previously published CONSENSUS trial. After this initial investigation of muscle metabolism in patients with chronic heart failure, the influence of the angiotensin converting enzyme inhibitor, enalapril, on skeletal muscle metabolism was studied by randomizing the patients in a double-blind manner to receive either placebo (n = 11) or enalapril (n = 11) in addition to conventional treatment. At the time of inclusion, the muscle content of energy-rich compounds, i.e. glycogen and the high energy phosphates, adenosine triphosphate (ATP) and phosphocreatine, was reduced as compared with healthy subjects and muscle lactate content tended to be higher than normal. Following study treatment, no significant changes occurred, neither within nor between the two subgroups. Thus, patients with severe chronic congestive heart failure display metabolic derangement in muscle, which, in this study, was not corrected by treatment with enalapril.

Adenosine Triphosphate↗
PubMed1992

Lipoprotein metabolism following gastroplasty in obese women.

In order to elucidate the long-term alterations in cholesterol transport and esterification as a part of the changes in the carbohydrate and lipoprotein metabolism subsequent to calorific restriction, 15 obese women were investigated before and after treatment with vertical banded gastroplasty. Insulin resistance and production, lipid levels in plasma, lipoproteins and the lecithin: cholesterol acyl transferase (LCAT) rate were assessed. There was a 60% decrease in mean calorific intake six months after surgery. A slight hyperglycaemia was almost normalized concomitant with a reduction of serum insulin and C-peptide after 1 year. The very low density lipoprotein (VLDL) level was unchanged. The high density lipoprotein (HDL) levels tended to rise after 1 year, when there was a significant increase of the HDL-2 subfraction. The lipid levels in the lipoprotein fractions showed a rise in mean HDL-2 cholesterol. Both the molar and fractional rates of LCAT were decreased. These results suggest that long-term calorific restriction reduces insulin resistance and production, and lowers VLDL levels and VLDL and cholesterol synthesis. However, the low density lipoprotein cholesterol levels are unchanged, probably because of a decrease in the previously elevated fractional cholesterol removal.

Adult↗
PubMed1992

Effect of pancreaticobiliary diversion on liver regeneration.

To ascertain whether the increase in cholecystokinin (CCK) level associated with pancreaticobiliary diversion has a cytoproliferative effect on the liver similar to that on the pancreas, we studied three groups of rats: group I (n = 19) had a pancreaticobiliary diversion and 4 weeks later a 70% liver resection, group II (n = 13) had a liver resection only, and group III (n = 6) underwent a sham liver operation. Tissue samples were taken from the liver and pancreas 48 h after the liver operation. Liver regeneration was evaluated on the basis of continuous incorporation of tritiated thymidine into hepatocytes, liver weight, and DNA content. For confirmation of the increase in CCK levels the effects on the pancreas was studied by measuring wet weight, total protein, and total DNA content. The results showed trophic effects on the pancreas, as expected, but no effects whatsoever on liver regeneration. CCK does not seem to have any role in the regulation of liver regeneration.

Animals↗
PubMed1991

Peripheral parenteral nutrition: effect of a standardized compounded mixture on infusion phlebitis.

The incidence and severity of infusion phlebitis was evaluated prospectively in 142 surgical patients who received peripheral parenteral nutrition (PPN) for a total of 700 days. In a first study phase 83 patients were given PPN for a total of 424 days. All nutrient solutions were delivered over a 12-h period from a 3-litre bag and the infusion sites rotated daily. These methods resulted in an incidence of phlebitis of 18 per cent, 75 per cent of the patients being fed successfully by PPN until resumption of oral nutrition. In an attempt to assess the importance of the method of delivering nutrient solutions, the next 59 patients were randomized to receive PPN as a compounded mixture or by a conventional technique with simultaneous infusion from separate bottles. Infusion phlebitis was significantly more frequent (P less than 0.001) in patients infused with separate bottles. There was no difference between the groups with regard to duration of nutrition or the need to establish central venous access. We conclude that PPN is a safe and cost-effective means of providing total parenteral nutrition in most surgical patients. The use of compounded mixtures significantly reduces the incidence of phlebitis without increasing total costs.

Aged↗