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Biomedical subjects

J Lindquist

Publications and source records attributed to J Lindquist.

At least 19 recordsLinked to original sources

Ten-year mortality for patients discharged after hospitalization for chest pain or other symptoms raising suspicion of acute myocardial infarction in relation to hospital discharge diagnosis.

AIM: To describe the 10-year prognosis for patients discharged after hospitalization for chest pain or other symptoms giving an initial suspicion of acute myocardial infarction (AMI) in relation to the final hospital diagnosis and furthermore to compare the outcome amongst these patients with the outcome amongst a sex-, age- and community-matched control population. METHODS: All patients who were hospitalized because of chest pain or other symptoms raising a suspicion of AMI and who were discharged alive from hospital. Patients were divided into three groups according to the final diagnosis: (1) confirmed or possible AMI, (2) confirmed or possible myocardial ischaemia and (3) other aetiology. Information on 10-year mortality was available in 3103 patients. A sex-, age- and community-matched control population (n=3221) was compared with the study population in terms of 10-year mortality. TIME OF SURVEY: 15 February 1986 to 9 November 1987. SETTING: Sahlgrenska University Hospital. RESULTS: Patients with confirmed or possible AMI (n=849) had a significantly higher mortality (59.4%) than patients with confirmed or possible myocardial ischaemia (n=1191) who had a mortality of 49.5% (P < 0.0001). The latter group had a higher mortality than patients with 'other aetiology' (n=1063) of whom 40.6% died (P < 0.0001). When comparing the prognosis for patients with AMI and myocardial ischaemia, there was a significant interaction with sex, with a more marked difference in women than in men. Amongst all patients, the 10-year mortality was 49.1 vs. 37.3% in the control group (P < 0.0001). CONCLUSION: The very long term prognosis was strongly associated with diagnosis amongst patients hospitalized and discharged alive because of chest pain or other symptoms raising suspicion of AMI. The absolute mortality difference between patients who were discharged from hospital with confirmed diagnosis of AMI and those whose symptoms were considered to have other aetiology than AMI or ischaemia was nearly 20%. However, the absolute mortality difference between the patients included in the survey and a control population was only 12%.

Aged↗

The 5' stem-loop regulates expression of collagen alpha1(I) mRNA in mouse fibroblasts cultured in a three-dimensional matrix.

The stability of collagen alpha1(I) mRNA is regulated by its 5' stem-loop, which binds a cytoplasmic protein in a cap-dependent manner, and its 3'-untranslated region (UTR), which binds alphaCP. When cultured in a three-dimensional gel composed of type I collagen, mouse fibroblasts had decreased collagen alpha1(I) mRNA steady-state levels, which resulted from a decreased mRNA half-life. In cells cultured in gel, hybrid mouse-human collagen alpha1(I) mRNA with a wild-type 5' stem-loop decayed faster than the same mRNA with a mutated stem-loop. When the 5' stem-loop was placed in a heterologous mRNA, the mRNA accumulated to a lower level in cells grown in gel than in cells grown on plastic. This suggests that the 5' stem-loop down-regulates collagen alpha1(I) mRNA. Protein binding to the 5' stem-loop was reduced in cells grown in gel, which was associated with destabilization of the collagen alpha1(I) mRNA. In addition to the binding of a cytoplasmic protein, there was also a nuclear binding activity directed to the collagen alpha1(I) 5' stem-loop. The nuclear binding was increased in cells grown in gel, suggesting that it may negatively regulate expression of collagen alpha1(I) mRNA. Binding of alphaCP, a protein involved in stabilization of collagen alpha1(I) mRNA, was unchanged by the culture conditions.

3T3 Cells↗

Analysis of film coating thickness and surface area of pharmaceutical pellets using fluorescence microscopy and image analysis.

A method is presented which enables geometrical characterisation of pharmaceutical pellets and their film coating. It provides a high level of details on the single pellet level. Image analysis was used to determine the coating thickness (h) applied on the pellets and the surface area (A) of the pellet cores. Different definitions of A and h are evaluated. Hierarchical analysis of variance was used to resolve different sources contributing to the total variance. The variance within pellets and the variance between pellets were found as significant sources of variation. Special emphasis was put on evaluation of A/h due to its influence on the release rate of an active drug substance from the pellet core. The pellet images were thus used to predict variations in the release rate using a mathematical model as a link between the image data and the release rate. General aspects of image analysis are discussed. The method would be useful in calibration of near infrared spectra to h in process analytical chemistry.

Microscopy, Fluorescence↗

The geriatric patient in surgery. Experience with patients over the age of 85 years.

Between 1982 and 1989 hospitalized treatment was applied to 615 patients aged between 85 and 101 years. The average age was 88.8 years. Operations were performed on 406 of them (66.1%). The surgical lethality amounted 16.5%. The lethality in conjunction with emergency operation was as high as 30.8% or as low as 10.7% in the context of elective operations. X-ray findings recorded from heart and lung as well as ECG provided reliable criteria for assessment of the surgical risk.

Age Factors↗

Conversion operation Billroth II into Billroth I with jejunal interposition.

First, under consideration of the erroneous operative often techniques often found in patients with B II gastrectomy, all functional complaints of these patients should prompt the consultant to recommend conversion surgery. Secondly, all recurrent ulcerations, whether peptic or anastomositis, represent an indication for conversion surgery. Last but not least reconstruction of normal nutrition passage in an important indication for surgery in patients with B II gastrectomy, restoring near physiologic passage circumstances. Particularly grave in its consequences is the gastric stump carcinoma with its fateful and irrevocable course for patients with B II gastrectomy if regular gastroscopic and laboratory follow-up inspection do not take place (regardless of questionable operation indication). We recall a tragic case of a woman with B II gastrectomy who refused conversion surgery despite histologic verification of metaplasia, who died of gastric stump carcinoma a year later.

Anastomosis, Surgical↗

[Experiences with early postoperative enteral tube feeding].

Over a period of 2 years 234 patients scheduled for major intraabdominal surgery were fed postoperatively via fine needle jejunostomy catheter. Nutrition ensued directly after surgery. Mean period of nutrition was 7.8 +/- 1.5 days. Care of the catheter was simple and secure. Compatibility with formula nutrition was good. Pertaining to catheter related complications, 25 patients presented diarrhoea, which was generally tolerable. Occasionally, flatulence and nausea occurred. In one patient, catheter nourishment had to be discontinued because of diarrhoea. One further discontinuation occurred due to postoperative non-catheter-related ileus. Clinical postoperative progress and laboratory findings showed no negative results relating to this form of nutrition.

Aged↗

Degradation pathway of pralidoxime chloride in concentrated acidic solution.

The degradation products of pralidoxime chloride (1) (X- = Cl-) in concentrated aqueous solutions (less than or equal to 50% w/v) were identified using one or more methods: HPLC, polarography, voltammetry, MS and/or NMR. The products found were the 2-cyano-, 2-carboxamido- and 2-carboxy-1-methyl-pyridinium chlorides, 1-methyl pyridinium chloride, cyanide ion, ammonia and carbon dioxide. 1-Methyl-2-pyridone was indirectly identified by the presence of cyanide ion. The degradation rate increased with increasing pH values between pH 1 and 3.2 and with increasing concentrations between 1 and 50% w/v pralidoxime chloride. The results suggest that 1 (X- = Cl-) is dehydrated by a hydroxyl-ion catalyzed reaction ot the nitrile 2 which is hydrolyzed to either the pyridone 6 and cyanide ion or to 2-carboxamido-1-methyl-pyridinium chloride 3. The amide is hydrolyzed to give the 2-carboxy derivative 4 which finally is decarboxylated to give 1-methylpyridinium chloride 5.

Chemistry, Pharmaceutical↗

Determination of water in penicillins using fast Karl Fischer reagents and electronic end-point optimization.

When using conventional Karl Fischer reagents for titration of water in penicillins, decomposition products (i.e. penicilloic acid) are shown to be partly cotitrated. Water in ampicillin, bacampicillin, carboxybenzylpenicillin and cloxacillin was titrated with slow and fast reagents and the differences in the results obtained were compared with the content of penicilloic acid determined mercurimetrically. A simple electronic control unit has been developed to optimize the speed of titration.

Journal Article↗

Proximal renal tubular dysfunction in severe burns.

Proximal renal tubular function was studied in 11 patients with severe burn injury. Creatinine clearance was normal or increased in ten patients. Fractional excretion of sodium was less than 1% in ten. Fractional excretion of uric acid and amylase were increased in all but four and two cases, respectively, while absolute clearances of lysozyme and beta 2-microglobulin were increased in all but one patient. Renal threshold phosphate concentration was reduced in four patients. Twenty-four-hour urine glucose excretion exceeded 1 g in five patients, aminoaciduria was noted in eight, and proteinuria, predominantly globulinuria, was present consistently. Metabolic acidosis was seen in one patient, and transient hypokalemia occurred in two. Abnormalities of proximal tubular function were more marked in the five patients with the greatest extent of third-degree burns who died. The cause of proximal tubular dysfunction is not clear and may be related to an adaptive response to severe injury.

Adult↗