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Biomedical subjects

J Mehlsen

Publications and source records attributed to J Mehlsen.

69 records · Page 4Linked to original sources
PubMed1987

Heart rate response to breathing: dependency upon breathing pattern.

Heart rate responses to stepwise and periodic changes in lung volume were studied in seven young healthy males. Stepwise inspiration and expiration both resulted in an increase in heart rate followed by a rapid decrease in heart rate. The fastest heart rate was reached in 1.6 +/- 0.5 s and in 3.6 +/- 1.4 s in response to inspiration and expiration, respectively (P less than 0.01). The slowest heart rate was reached in 4.8 +/- 1.0 s and in 7.6 +/- 1.9 s in response to inspiration and expiration, respectively (P less than 0.01). Following this biphasic change the heart rate returned to a steady level. The difference between the fastest and the slowest heart rates was significantly larger in response to inspiration (21.7 +/- 7.3 beats per minute) than in response to expiration (12.0 +/- 7.3 beats per minute; P less than 0.01). Periodic changes in lung volume were performed with frequencies from 3.0 to 12.0 respirations per minute (r.p.m.). The changes in heart rate showed a constant amplitude in the frequency range below 5.5 r.p.m. Maximal heart rate changes were found at frequencies of 5.5 to 7.0 r.p.m. Changes in heart rate decreased in a linear manner on a log-log scale in the frequency range above 7.0 r.p.m. The relation between frequency and changes in heart rate is explained by interference between the transient changes in heart rate induced both by inspiration and by expiration. It is concluded that if heart rate changes in response to periodic changes in lung volume are to be used as a measure of vagal function a number of factors have to be taken into consideration and to simplify the analysis of heart rate responses to breathing we recommend, instead, the use of the transient changes in heart rate induced by stepwise changes in lung volume.

Adult↗
PubMed1987

Progressive central hypovolaemia in man--resulting in a vasovagal syncope? Haemodynamic and endocrine variables during venous tourniquets of the thighs.

Hypotensive functional haemorrhage induced by venous pooling of blood in the legs has been reported to be characterized by a vasovagal reaction. In the present study these observations were extended by determination of the hormonal profile developed during progressive central hypovolaemia and an emotionally induced vasovagal syncope. In six subjects venous pooling resulted in normotensive central hypovolaemia, in one subject hypotensive central hypovolaemia was induced, and one subject experienced an emotionally induced vasovagal syncope. During normotensive central hypovolaemia heart rate increased from 58 +/- 4 to 76 +/- 4 beats min-1 (P less than 0.05) and cardiac output fell from 6.1 +/- 0.4 to 4.1 +/- 0.2 1 min-1. Pulse pressure and central venous pressure decreased from 64 +/- 4 to 53 +/- 4 mmHg, and from 8 +/- 2 to 3 +/- 2 mmHg, respectively. Adrenaline and noradrenaline increased from 87 +/- 10 to 120 +/- 20 pg/ml and from 196 +/- 33 to 370 +/- 50 pg/ml, respectively. Angiotensin II increased from 13 +/- 4 to 36 +/- 6 pg/ml and aldosterone from 63 +/- 9 to 180 +/- 27 pg/ml. In hypotensive central hypovolaemia the decrease in mean arterial pressure was accompanied by a decrease in heart rate and increments in the plasma concentrations of pancreatic polypeptide, indicating increased vagal activity and beta-endorphin, while plasma noradrenaline was unchanged. In emotionally induced syncope heart rate decreased to cardiac arrest for 13 s, associated with increments in the plasma concentrations of pancreatic polypeptide and beta-endorphin. It is concluded that normotensive functional haemorrhage in man is associated with increased sympathetic activity and that the qualitatively similar observations obtained during an emotionally and a hypovolaemic-induced hypotensive episode indicate that the hypotensive functional haemorrhage is characterized by a vasovagal reaction.

Adult↗
PubMed1987

Substantial effect of acute hydration on blood pressure in patients with autonomic failure.

The effect of acute hydration on arterial blood pressure levels was investigated in ten patients with severe postural hypotension due to autonomic failure. Blood pressure and heart rate were determined in the supine and 60-degree head-up tilted position. Plasma volume and left ventricular ejection fraction were measured in the supine position. Measurements were repeated after rapid infusion of 11 of isotonic saline. Acute hydration resulted in increased supine mean blood pressure levels (P less than 0.01) despite normal plasma volumes in all patients. The postural reductions in mean blood pressure were reduced from 40 mmHg before to 20 mmHg after saline (median values, P less than 0.01). The results indicate that normal plasma volumes do not ensure optimal circulatory status in patients with autonomic failure. Acute hydration with isotonic saline may be used for immediate corrections of blood pressure levels in patients with autonomic failure and the response to acute hydration may be used as an indicator of the circulatory status in these patients.

Adult↗
PubMed1987

Increased sympathetic tone in forearm subcutaneous tissue in primary hypothyroidism.

Sympathetic reflex regulation of subcutaneous blood flow (SBF) in the forearm was studied in eight patients with primary hypothyroidism. Diastolic arterial pressure was greater than or equal to 95 mmHg in five patients. SBF was determined by local clearance of Na99mTcO4. Sympathetic vasoconstriction normally seen after lowering the forearm 40 cm below heart level was absent since SBF only decreased by 4% (+/- 7%, P greater than 0.1) during these conditions. In head-up vertical position we noticed a diminished baroreceptor response as SBF at heart level was reduced by 11% (+/- 7%, P greater than 0.1) compared to supine position. After proximal local anaesthesia SBF increased by 351% (+/- 81%, P less than 0.01) and disclosed a normal vasoconstrictor response as SBF was reduced by 53% (+/- 5%, P less than 0.01) during arm lowering. Five of the treated patients were restudied in the euthyroid state. Mean arterial pressure was reduced in mean by 20 mmHg (+/- 6 mmHg, P less than 0.02) during treatment and a significant vasoconstriction was observed both during arm lowering (SBF = -52% (+/- 6%, P less than 0.02)) and in head-up vertical position (SBF = -45% (+/- 11%, P less than 0.02)). In conclusion sympathetic vasoconstrictor activity in adipose tissue is markedly increased in primary hypothyroidism. Sympathetic tone and arterial pressure are reduced during treatment.

Adult↗
PubMed1987

Blood-retinal barrier permeability versus diabetes duration and retinal morphology in insulin dependent diabetic patients.

The blood-retinal barrier permeability to fluorescein was quantitated in 54 patients (22 females and 32 males) with insulin dependent diabetes mellitus (IDDM) of different duration. Correlation was demonstrated between permeability and diabetes duration. A normal permeability was measured in patients with up to ten years diabetes duration. A pathologically increased permeability was measured with ten to 15 years diabetes duration and during the next decade the permeability increased rapidly to 5-10 times the normal value. Onset of diabetes in the decade before and after puberty did not change the pattern. However, the pathologically increased permeability after ten years duration of the disease could not be demonstrated in diabetics with onset of the disease after the age of 30 years. The permeability of the blood-retinal barrier correlated well with changes in retinal morphology as seen by ophthalmoscopy and fluorescein angiography. However, there was an overlap in permeability between groups with different retinal appearance. A significant factor was the presence of macular edema, which also apparently indicated a preproliferative state.

Adolescent↗
PubMed1987

Relationship between subcutaneous blood flow and absorption of lente type insulin.

To study the relationship between the absorption of intermediate acting insulin and the local subcutaneous blood flow (SBF) 8 diabetic patients were given subcutaneous injections of 125I labeled human lente type insulin and 133Xenon in the abdominal wall. External measurements of the tracer disappearance were performed and the insulin absorption rate and SBF were calculated. A curvilinear relationship between the insulin absorption rate and SBF was demonstrated with an initial almost linear relation but with decreasing impact of SBF when this was in the higher physiological range.

Absorption↗
PubMed1986

Evaluation of left ventricular volumes measured by magnetic resonance imaging.

Left ventricular end-diastolic and end-systolic volumes were determined in 17 patients with different levels of left ventricular function by magnetic resonance imaging (MRI). A 1.5 Tesla Magnet was used obtaining ECG triggered single and multiple slices. Calculated cardiac outputs were compared with those measured simultaneously by a classical physiological indicator dilution technique. There was good agreement between cardiac output as measured by MRI and the indicator dilution method, when the multislice technique was used (r = 0.87, p less than 0.001). A poor correlation between the two methods was seen when the single slice technique was used (r = 0.06, p greater than 0.80). The results indicate that MRI is a reliable method for left ventricular volume determination when the multislice technique is used.

Adult↗
PubMed1986

Xamoterol, a new selective beta-1-adrenoceptor partial agonist, in the treatment of postural hypotension.

Three patients severely disabled from postural hypotension were treated with xamoterol, a selective beta-1-adrenoceptor antagonist with a high degree of partial agonist activity. Oral treatment (200 mg b.i.d.) was chosen on the basis of the effects of acute intravenous administration of xamoterol and pindolol, a non-selective beta-adrenoceptor antagonist with partial agonist activity. In these patients pindolol had a predominantly antagonist effect, whereas xamoterol had a predominantly agonist effect after intravenous administration. Oral treatment was carried out with placebo control in a single-blind fashion. The patients reported gradual improvement during the first days of treatment. After 1 month of oral treatment, heart rate had increased by 15 beats/min, systolic blood pressure from 131 to 170 mmHg, diastolic blood pressure from 77 to 91 mmHg and mean blood pressure by 22 mmHg (mean values, supine). During the placebo period (2 weeks) heart rate decreased to pretreatment levels and mean blood pressure was reduced by only 14 mmHg. The patients reported substantial improvement in their condition during active medication. Xamoterol seems to be a useful alternative in the treatment of postural hypotension.

Adrenergic beta-Agonists↗
PubMed1986

The blood-retinal barrier permeability to fluorescein in normal subjects and in juvenile diabetics without retinopathy.

The blood-retinal barrier permeability to fluorescein was determined in 20 eyes from 17 normal volunteers (mean age 31 years) and in 20 eyes from 19 juvenile diabetics without apparent retinopathy (mean age 35 years - mean duration of diabetes 6 years). The permeability was in normal subjects (1.1 +/- 0.4) X 10(-7) cm/sec (mean +/- 2 X SD) and in juvenile diabetics (1.1 +/- 0.7) X 10(-7) cm/sec (mean +/- 2 X SD). Thus a break-down of the blood-retinal barrier cannot be demonstrated as a very early and general phenomenon in the early course of the diabetic disease. The fluorescein diffusion coefficient in the vitreous body was determined and juvenile diabetics without apparent retinopathy showed a diffusion coefficient of (0.80 +/- 0.25) X 10(-5) cm2/sec (mean +/- 2 X SD), which was the same as in normals where the diffusion coefficient was (0.69 +/- 0.46) X 10(-5) cm2/sec (mean +/- 2 X SD).

Adolescent↗
PubMed1985

Mild mental stress in diabetes: changes in heart rate and subcutaneous blood-flow.

A TV-game of tennis of 20 min duration was used to study the influence of mild mental stress on subcutaneous blood-flow (SBF), blood-pressure and heart rate in nine insulin-dependent diabetics and nine healthy subjects. SBF was measured on the thigh by local clearance of xenon-133. Measurements were made before, during and after the period of stress. During stress, SBF increased significantly by 26% in the healthy subjects, while SBF remained unchanged in the diabetics. The difference between the two groups was significant (P less than 0.05). Following stress, SBF returned to pre-stress level in the healthy subjects, while a significant decrease of 33% was observed in the diabetics. The pre-stress heart rate level was higher and the stress-induced increase in heart rate was less in the diabetics compared with the healthy subjects (P less than 0.05). During the stress a slight--but insignificant--increase in blood-pressure was observed in both groups. In conclusion, we found that even mild mental strain influences SBF in both normal subjects and in diabetics. The induced alterations in the two groups are different, probably because of a slight parasympathetic dysfunction in the diabetics.

Adult↗
PubMed1983

T lymphocyte subsets in patients with newly diagnosed type 1 (insulin-dependent) diabetes: a prospective study.

T lymphocyte subsets in peripheral blood from 11 newly diagnosed Type 1 (insulin-dependent) diabetic patients were studied prospectively at three time intervals: as soon as possible after diagnosis, 3 weeks and 5 months later. Lymphocytes were marked with monoclonal OKT antibodies and examined in a fluorescence-activated cell sorter. The percentage of T lymphocytes (OKT3) did not change significantly at the three study times. The percentage of helper/inducer T cells (OKT4) was high the first week after diagnosis, but decreased at the 5-month examination (p less than 0.05). The percentage of suppressor/cytotoxic T cells (OKT8) was low at diagnosis but increased at 3 weeks (p less than 0.02) and 5 months (p less than 0.01). The ratio OKT4/OKT8 lymphocytes was 2.28 at diagnosis, decreasing to 1.77 at 3 weeks and 1.87 at 5 months, compared with 1.46 for 16 age-matched control subjects. There was no significant change in the absolute number of lymphocytes. It is concluded that the distribution of T cell subsets was abnormal at the time of diagnosis, but changed towards normal within a few weeks, after which there was no significant change at 5 months. It is as yet unknown whether the high proportion of helper/inducer T cells and/or the low percentage of suppressor/cytotoxic T cells at diagnosis favour immune reactions involved in the pathogenesis of Type 1 diabetes.

Adolescent↗
PubMed1983

Alterations of peripheral T-lymphocyte subpopulations in patients with insulin-dependent (type 1) diabetes mellitus.

Subpopulations of peripheral T-lymphocytes were studied in two groups of patients with insulin-dependent diabetes mellitus (IDDM): eleven newly diagnosed diabetics and twenty-one patients having diabetes of long duration (13 +/- 1 yr). Monoclonal antibodies to the surface antigens of helper (OKT 4) and suppressor (OKT 8) T-cell subsets and to a common T-cell antigen (OKT 3) were used. The percentage of suppressor T-lymphocytes were found reduced in both the newly diagnosed patients (p less than 0.001) and the patients with long-term IDDM (p less than 0.05) in comparison with 16 age-matched healthy control persons. Furthermore, the newly diagnosed diabetics showed a lower percentage of suppressor T-cells (p less than 0.05) and a higher amount of helper T-cells (p less than 0.01) than the patients with long-term diabetes. Concerning the percentage of the total number of T-cells and the absolute number of lymphocytes, there were no significant differences between the patient groups and the controls. As earlier studies have pointed to the significance of immune reactions in diabetogenesis, a pathogenetic importance of the observed imbalance of subpopulations of T-lymphocytes in IDDM should be considered.

Adult↗
PubMed1981

The blood-retinal barrier permeability in diabetic patients.

By the of aid an extended corpus vitreum fluorophotometric technique, the blood-retinal barrier permeability for fluorescein was studied in diabetologically well characterized patients with insulin dependent diabetes mellitus. The method, which involves simultaneous determination of the fluorescein concentration in corpus vitreum and plasma, is described and discussed. A clear correlation was found between the degree of retinopathy and permeability (P). Patients with normal visus, ophthalmoscophy, fundus photo and fluorescence angiography exhibited P-values of 1.10(-7) cm . sec-1. This was similar to P-values found in normal volunteers. Simplex retinopathy without macular oedema showed values of 2.5 . 10(-7) cm . sec-1 while simplex retinopathy with macular oedema showed P-values of 10 . 10(-7) cm . sec-1.

Capillary Permeability↗