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Biomedical subjects

K A Angquist

Publications and source records attributed to K A Angquist.

52 records · Page 3Linked to original sources

Blood groups and HLA antigens in patients with abdominal aortic aneurysms.

Frequencies of blood groups (ABO, Rh, MNSs, P, Kell, Lewis and Duffy) and HLA antigens were studied in a series of patients from northern Sweden with abdominal aortic aneurysms. The following significant differences from the controls were found: a decreased frequency of the Rh-negative blood group and increased frequencies of the Kell-positive and MN blood groups. Previously reported associations with the ABO and Rh systems were not confirmed.

ABO Blood-Group System↗

Familial occurrence of abdominal aortic aneurysms.

The occurrence of clinically diagnosed and ruptured abdominal aortic aneurysms (AAAs) in the family was studied retrospectively among 200 consecutive patients with AAAs treated at the Surgical Clinic, University Hospital of Umeå, in the north of Sweden, during the period 1965 to 1981. A standardized questionnaire was sent to the 89 patients who were still alive when the study was performed, and 87 patients answered it. In 14 of these families there was one blood relative with AAA, and in two families there were two blood relatives with AAAs, apart from the proband. In nine cases AAAs occurred among the 468 brothers and sisters of the probands (1.9%), and in five cases among cousins. Seven of the 204 deceased brothers and sisters (3.4%) had died of ruptured AAAs. No questionnaires were sent to the families of the 111 deceased patients, but at least 11 of these patients had AAAs in the family. Pedigrees of the families with aggregation of aneurysms are presented, and fortuitous familial aggregation or predisposition to the development of AAAs is discussed.

Adult↗

Morphometric analyses of human muscle fiber types.

Fibers from the m. vastus lateralis of 10 middle-aged men were classified at ultrastructural level according to the appearance of the sarcomeric M-band. The Z-band widths had a two-peak distribution. One peak was due to type 1 fibers (mean 125 +/- 11 nm), the other to type 2 fibers. This latter could be separated into type 2A (101 +/- 9 nm) and type 2B (86 +/- 8 nm). About 83% of the fibers would have been correctly classified on the basis of the Z-band width alone. Mitochondrial volumes differed (type 1 5.6 +/- 0.8, 2A 4.0 +/- 0.8, and 2B 2.8 +/- 0.8%). However, only one third (37%) of the fibers would have been correctly classified if sorted according to this parameter. Mitochondrial volumes in the different fibers were correlated to mitochondrial enzymes, while fiber sizes and numbers were correlated to cytoplasmic variables. The correlations appeared mainly after a training program, suggesting that the relationships between structural and functional parameters are more obvious after adaptation to higher functional demands.

Adult↗

Z- and M-band appearance in different histochemically defined types of human skeletal muscle fibers.

In order to define ultrastructural features, which alone or in combination with other features could be used to identify different types of fibers in human skeletal muscle, frozen biopsy specimens of m. tibialis anterior were serially sectioned. The thawed sections were prepared either for enzyme histochemistry or for electron microscopy. The same fiber was then identified in all serial sections and its ultrastructure examined under the electron microscope. A total of 75 fibers were included in this investigation. Specimens were also conventionally prepared for electron microscopy. Special interest was devoted to the appearance of the sarcomeric Z- and M-bands. In the same fiber, all myofibrils showed the same Z- as well as M-band structure. On the other hand, it was evident that these structures varied from one type of fiber to another in the same muscle and that their appearance were covariant to a great extent. Low level resolution of Type 1 fibers usually showed broad Z- and M-bands with five strong M-bridge lines. In Type 2A fibers intermediate Z-bands were observed. In the middle portion of the M-bands, three strong M-bridge lines were distinct while the two outer lines were relatively weak. Finally, Type 2B fibers usually appeared with narrow Z-bands. The three M-bridge lines in the middle were strong while the two outer ones were very weak, if seen at all. Discriminant analysis showed that about 70% of the fibers should have been correctly allocated on the basis of the Z-band width alone. When two independent observers classified the fibers on the basis of M-band appearance, more than 95% of the fibers were correctly classified. Thus, both the Z- and M-bands, alone or in combination, can be used as fiber type discriminators. However, the M-band structure proved to be more reliable than the Z-band width, and should therefore be used as the fiber type indicator when only one of these parameters is considered.

Freezing↗

Serum lipoproteins and apolipoproteins A I and A II in male patients with peripheral arterial insufficiency.

Serum apolipoprotein A I and A II concentrations and triglyceride and cholesterol concentrations in serum lipoprotein density classes were determined in male patients with peripheral arterial insufficiency (PAI) and in controls. Both triglyceride and cholesterol concentrations in serum, very low and low density lipoproteins were higher in PAI patients than in controls. The cholesterol in high-density lipoproteins and the serum apolipoprotein A I concentration were lower in PAI patients than in controls. No difference between the groups was found for serum apolipoprotein A II concentration. The results show that the lipoprotein pattern in PAI is changed in roughly the same way as in ischemic heart disease.

Adult↗

Diaphanoscopy and diaphanography for breast cancer detection in clinical practice.

Transillumination of the female breast has during the past few years been reintroduced as an aid in the diagnosis of breast lesions. A series of 259 women with symptoms from the breast were examined by mammography, clinical examination by two independent surgeons, diaphanoscopy by one of the surgeons, diaphanography, and fine needle aspiration biopsy of material taken from palpable tumours. The results were evaluated in order to ascertain the contribution made by transillumination procedures to the diagnosis of malignancy. Carcinoma of the breast was confirmed in 26 women. The malignancy was correctly suggested in 21 and 23 women, respectively, at clinical examination, in 19 by mammography, in 20 by diaphanoscopy, in 16 by diaphanography and in 20 by aspiration cytology. The number of false positive cases was high, especially with the transillumination procedures. All malignancies detected by diaphanoscopy were also believed to be carcinoma at the clinical examination. The three cancers falsely classified as benign at clinical examination were correctly identified as malignant only by mammography or cytology or both.

Adult↗

Physical training in man. Skeletal muscle metabolism in relation to muscle morphology and running ability.

The metabolic and morphologic adaptation to physical training in skeletal muscle tissue of eleven middle-aged, physically untrained men was studied. Muscle biopsies were taken from the vastus lateralis before, after 8 weeks and after 6 months of physical training for analysis of metabolic and morphologic variables. Glucose tolerance test indicated increased insulin sensitivity after 6 months of physical training. The activities of glycogen phosphorylase, hexokinase and glucose-6-P-dehydrogenase were increased but other enzymes involved in glycogen turnover and glycolysis were unchanged after 6 months of physical traning. The activities of citrate synthase and cytochrome-c-oxidase, representing the oxidative capacity were significantly increased already after 8 weeks of physical training. The incorporation rate of palmitate-carbon into CO2 and triglycerides increased, and the incorporation rate of leucine-carbon into CO2 decreased with 6 months of physical training. The fiber diameter of both Type 1- and Type 2-fibers increased, while the mitochondrial volume increased predominantly in Type 2-fibers. Significant correlations were found between metabolic, physiologic and morphologic variables before and after physical training. The results indicate an increased oxidative capacity, mainly located to Type 2-fibers, and an increased utilization of fatty acids in response to this type of physical training.

Carnitine↗

Bilateral aneurysm of dacron graft following aorto-femoral graft operation. A case report.

A case of bilateral aneurysmatic widening of the Dacron graft after aorto-femoral bypass is described. The probable cause of an aneurysm in Dacron graft without any involvement of the host vessels may be the rupture of the Dacron fibres due to fatigue of the material. Furthermore, a contributory cause of aneurysm in our case may be the fact that both anastomoses were performed at nearly right angles causing turbulence.

Aorta, Abdominal↗

Ectopic liver lobule with portal cirrhosis.

A patient who had an ectopic liver attached to the gallbladder is reported. Angiography, scintiscanning, and routine palpation at laparotomy did not reveal the ectopic liver. Advanced liver cirrhosis was found in autopsy and the same changes were seen in the ectopic liver. The embryology, localization, symptoms and incidence of ectopic liver lobules are discussed.

Adult↗

Intermittent claudication and muscle fiber fine structure: morphometric data on mitochondrial volumes.

The mitochondrial volume densities (Vmit) of the different fiber types (type 1, type 2A, type 2B) were estimated in bilaterally obtained biopsies from 22 patients with unilateral intermittent claudication. These data, which were obtained from structurally intact fibers, were compared with clinical data from the same subject. In both the asymptomatic and symptomatic legs, Vmit 1 greater than Vmit 2A greater than Vmit 2B. Furthermore, Vmit 1 covariated with Vmit 2A and Vmit 2A with Vmit 2B in the asymptomatic legs (as in healthy subjects) but not in the symptomatic legs. Vmit 2 (mainly Vmit 2A) covariated with the age of the subjects in both legs. Vmit Tot was higher in the symptomatic legs than in the asymptomatic legs. This was mainly due to increase in the oxidative fibers, type 1 and type 2A. Usually, Vmit in the asymptomatic legs covariated significantly with the results of the functional tests (initial pain and maximum walking tolerance), while only Vmit 2A in the symptomatic legs showed such a correlation. However, the difference between the two legs concerning Vmit 1 was also correlated to the walking tolerance. Patients with high stenosis or occlusion showed higher Vmit Tot than did those with low obstacles. The results conclusively show that a fiber type-specific adaptation to ischemia occurs through an increase of mitochondrial content of oxidative fibers, which suggests that hypoxia may influence the control of synthesis or degradation of mitochondrial proteins.

Biopsy↗

Intermittent claudication and muscle fiber fine structure: correlation between clinical and morphological data.

Bilaterally obtained muscle biopsies (anterior tibial muscle) from 22 patients with unilateral peripheral arterial insufficiency (intermittent claudication) were qualitatively and quantitatively analyzed by means of enzyme histochemistry and electron microscopy. In a majority of the biopsies from the symptomatic legs, two different patterns of morphological deviations were seen in the abnormal muscles: one suggested primary muscle fiber damage and the other indicated denervation. Biopsies from the asymptomatic legs were often only slightly changed or normal. Significant correlations were found in both legs between the relative number of type 1 (slow twitch, highly oxidative) fibers and the age of the subjects. In symptomatic legs, furthermore, a relation could be demonstrated between the relative number of type 1 fibers and (1) the initial walking tolerance (walking distance covered before pain occurred), (2) duration of symptoms, and (3) occlusion or stenosis at high level (i.e., above the deep femoral artery). Finally, the diameters of both type 1 and type 2 fibers in the symptomatic leg were correlated to the initial walking tolerance. The importance of circulatory disturbances as differential diagnostic points (arteriovasculo-occlusive myopathy) in the diagnosis of neuromuscular diseases is stressed.

Adult↗

A tactile sensor for detection of physical properties of human skin in vivo.

A spring loaded tactile sensor with displacement sensing has been evaluated for non-invasive assessment of physical properties, stiffness and elasticity, of human skin in vivo. The tactile sensor consists of a peizoelectric vibrator (61 kHz) with a vibration pickup, electronics and PC with software for measurement of the change in frequency when the sensor is attached to an object. Integrated with the tactile sensor is a displacement sensor that shows the compression of the spring that loads the sensor element against the object during measurement. Under certain conditions (e.g. fixed contact pressure) this change in frequency monitors the acoustic impedance of the object and is related to the stiffness of soft tissue. The experimental results on silicone gum and on healthy Japanese and Swedish women indicated that the instrument was able to detect changes in stiffness and elastic related properties of human skin, related to age, day-to-day variations and application of cosmetics. The instrument was concluded to be easy to handle and suitable for field work.

Adolescent↗

High concentrations of Lp(a) lipoprotein in serum are common among patients with abdominal aortic aneurysms.

The serum concentrations of Lp(a) lipoprotein was determined in 57 patients with abdominal aortic aneurysms (AAAs) and in 56 controls. Twentynine of the AAA-patients also suffered from other cardiovascular diseases and eleven had brothers and sisters with AAAs. Lp(a) was significantly higher among the AAA-patients than among the controls (22.3 +/- 24.3 vs 12.6 +/- 20.4 mg/dl, p less than 0.01). The 28 AAA-patients without other cardiovascular diseases had a somewhat higher Lp(a) in serum than the other AAA-patients, but this difference was not statistically significant (26.4 +/- 28.4 vs 18.5 +/- 19.3 mg/dl). The 11 AAA-patients with AAAs in the family didn't differ from the other AAA-patients concerning Lp(a) in serum. Several genetic markers were also studied, and the seven Kell-positive AAA-patients had a significantly lower Lp(a) in serum than the 47 Kell-negative AAA-patients (7.0 +/- 10.3 vs 25.7 +/- 25.2 mg/dl, p less than 0.05).

Aorta, Abdominal↗

Peripheral arterial insufficiency and the fine structure of the gastrocnemius muscle.

A detailed light- and electron microscopical study was carried out on biopsies from m. gastrocnemius of 14 male individuals with intermittent claudication. The morphometric data obtained showed a large number of significant correlations with clinical and physical parameters. Practically all sections also showed morphological abnormalities, such as a fibre necrosis, regeneration, angular fibres, fibre type grouping and abundant connective tissue. Finally, there were significant differences in the muscle fine structure between those patients recommended physical training and those selected for surgery. The results clearly show that the structure of the muscle fibres is well adapted to the functional circumstances. They also show that widespread fibre damage do occur in intermittently ischaemic musculature, even if no signs of macroscopical tissue damage are found at routine clinical examination. Furthermore, although the clinical and physical data on patients selected for physical training and vascular surgery respectively, are very similar, there seems to be other factors that clinically influence the differentiation of the patients into these two groups. When evaluating effects of different treatments on these two groups of patients, it is thus important to take into account that there may be differences in morphology even before they are subjected to the different treatments.

Biopsy↗

Isokinetic plantar flexor performance and fatiguability in peripheral arterial insufficiency. Effects of training vs. vascular surgery.

Seventeen men with peripheral arterial insufficiency and intermittent claudication (maximum walking tolerance less than 1000 m) underwent a bypass operation (group A, n = 8) or carried out simple exercises (repeated heel-raising) at home (group B, n = 9). The effects of treatment on the isokinetic performance of the plantar flexors and on fatiguability were assessed. Before treatment both groups had similarly low Doppler pressure indices, maximum performance and fatiguability level. Maximum walking tolerance was increased by treatment in both groups. Maximum plantar flexor output rose in group A, partly due to increased range of motion, but was only slightly changed in group B. Bypass surgery also led to increased electrical efficacy (contractional work/integrated electromyogram). Plantar flexor fatiguability normalized in six of the eight group A men, but in only a few from group B. Improvement in group B may be explained by specific adaptation of (mainly type 2B) muscle fibres. After bypass the increased capacity to remove combustion products may be the major reason for normalized fatiguability. Bypass surgery is preferable for most cases of intermittent claudication.

Arterial Occlusive Diseases↗