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Biomedical subjects

K Axelsson

Publications and source records attributed to K Axelsson.

At least 19 recordsLinked to original sources

Disulfide arrangement of human insulin-like growth factor I derived from yeast and plasma.

The disulfide arrangement of yeast derived human insulin-like growth factor I (yIGF-I) was determined using a combination of Staphylococcus aureus V8 protease mapping, fast-atom-bombardment mass spectrometry as well as amino acid sequence and composition analysis. Three disulfide bridges were found between the following cysteine residues: Cys6-Cys48, Cys47-Cys52 and Cys18-Cys61. IGF-I isolated from human plasma (pIGF-I) was found to have an identical disulfide configuration. A yeast-derived isomeric form of IGF-I (yisoIGF-I) exhibited an altered disulfide arrangement: Cys6-Cys47, Cys48-Cys52 and Cys18-Cys61. Radioreceptor analysis of pIGF-I and yIGF-I showed high specific activity, 20,000 U/mg. However, yisoIGF-I demonstrated a severely reduced ability to bind to the IGF-I receptor (19%) and was less potent in provoking a mitogenic response in Balb/C 3T3 fibroblasts (50% at doses 10-100 ng/ml). The data demonstrate the importance of correct disulfide arrangement in IGF-I for full biological activity.

Amino Acid Sequence

Sensory and motor blockade during epidural analgesia with 1%, 0.75%, and 0.5% ropivacaine--a double-blind study.

Levels of sensory (pinprick) and somatic motor blockade were measured in a double-blind study of 30 volunteers given single epidural injections of 1%, 0.75%, and 0.5% ropivacaine. Onset of analgesia was rapid with all concentrations (7-10 min). Maximal levels of analgesia were established 60 min after injection, with no significant differences in the maximal median cephalad spread. Duration of analgesia at the T-12 level and total duration were significantly longer with 1% and 0.75% than with 0.5% ropivacaine. Motor blockade was assessed by a quantitative method (measurements of isometric muscle force) and a qualitative method (modified Bromage scale). Onset of motor blockade measured by the quantitative method was significantly slower with 0.5% ropivacaine than with the higher concentrations. Maximal muscle weakness occurred 1-1.5 h after injection with all three concentrations. With increase in ropivacaine dose from 100 to 200 mg, the intensity and duration of motor blockade increased. Muscles involved in knee extension were blocked most, those of plantar flexion least. Recovery of motor function, assessed by the above-mentioned quantitative method, occurred simultaneously with the recovery of pinprick perception. Motor blockade registered by Bromage scale showed a slower onset for 0.5% ropivacaine than for the higher concentrations. Mean durations of grade 1 and 2 block were longest for the 1% solution. Motor blockade described by the Bromage scale showed only the first part of the regression phase. Full recovery of muscle strength (Bromage scale = 0) was attained 1.5-2.5 h earlier than assessed by the quantitative method. No adverse effects were registered.

Adult

Epidural anesthesia with 0.5% bupivacaine: influence of age on sensory and motor blockade.

To determine the influence of age on epidural blockade, 10 elderly male patients (mean age, 73 yr) and 11 young male volunteers (mean age, 25 yr) received epidural anesthesia with 20 mL of 0.5% bupivacaine with epinephrine at the L2-3 interspace. Median cephalad analgesia level (pinprick) was T-4 in the elderly and T-10 in the young subjects (P less than 0.01). The duration of analgesia at the L-1 to S-3 segments was about 60 min shorter in the older patients than in the young volunteers (P less than 0.05). Motor blockade was evaluated quantitatively by isometric muscle force measurements in the lower extremities and by electromyographic recordings from the abdominal and quadriceps muscles. Motor blockade in the lower extremities was also assessed qualitatively by the Bromage scale. The intensity of motor blockade was not influenced by age. The mean duration of maximal motor blockade of the lower abdominal muscles was 69 min in elderly patients and 140 min in young subjects (P less than 0.05). The corresponding mean duration in the lower extremities was approximately 1.5 h in the older patients and 3 h in the young subjects (P less than 0.01). The elderly patients could be mobilized 2 h earlier than the young volunteers. Duration of Bromage grade 1 was about 1.5 h shorter in the elderly than in the young subjects (P less than 0.01). Not until 1.5-2 h after attainment of Bromage grade 0 was the muscle force in the lower extremities restored to 90% of baseline value. The authors conclude that cephalad spread was more extensive and duration of epidural blockade was shorter in elderly patients versus younger volunteers.

Adult

Protein kinase C and casein kinase II activities in two human colon carcinoma cell lines, HT-29 and CaCo-2: possible correlation with differentiation.

Protein kinase C (PK-C) and casein kinase II (CK-II) activities were studied in two human colon carcinoma cell lines (HT-29 and CaCO-2) undergoing differentiation in vitro resulting, in small-intestine-like cells. CaCo-2 cells, when grown under standard conditions, appear to undergo spontaneous differentiation. In these cells PK-C and CK-II activities were determined on day 5, 10 and 15. No significant differences in activities were seen either in PK-C or CK-II activity. HT-29 cells, when grown in glucose-free medium can be stimulated to undergo differentiation which is completed within 20 days. PK-C and CK-II activities were determined after 5, 10, 15, 20 and 25 days, respectively. PK-C activity rose from 7.9 +/- 3.5 pmole 32P/mg protein/min at day 5 to 37.5 +/- 14.8 pmole 32P/mg protein/min at day 20. After 25 days the activity was reduced to 20.0 +/- 7.8 pmole 32P/mg protein/min. CK-II activity did not change significantly during day 5 to 20, but on day 25 there was a significant decrease in CK-II activity from 94.9 +/- 6.4 pmole 32P/mg protein/min (day 20) to 62.6 +/- 3.9 pmole 32P/mg protein/min (day 25) p = 0.003. The results in this study indicate a role for PK-C and CK-II in cell growth and differentiation.

Casein Kinases

Influence of intravenous local anaesthetics upon quadriceps muscle function.

This study was undertaken to assess the effects of intravenous administration of mepivacaine and etidocaine on muscle function. Seven male volunteers were given mepivacaine (5 mg/kg) and etidocaine (50 mg) intravenously, on separate occasions. A reference group of 11 male volunteers received 0.9% saline solution intravenously. Muscle function was tested by measurements of isometric muscle force of knee extension and by quantitative electromyographic (EMG) recordings from the quadriceps muscle during knee extension at different degrees of isometric muscle force. At the end of the mepivacaine and etidocaine infusions, the mean venous plasma concentrations of the two anaesthetic agents were 2.9 and 1.2 micrograms/ml, respectively. The muscle strength remained unchanged during infusion of the two local anaesthetics. Mepivacaine had a minor effect on the mean rectified EMG amplitudes at the end of the infusion at maximal voluntary muscle contraction, but no such effect was observed at submaximal knee extension force. However, at the plasma concentrations mentioned above, the clinical influence of intravenous infusion of the local anaesthetics on muscle function was negligible.

Adult

Separation and identification of growth hormone variants with high performance liquid chromatography techniques.

Liquid chromatography techniques were used to separate and identify human growth hormone (hGH) variants. N-terminal modified forms, such as des-Phe (2-191) and methionyl-hGH (met-1-191), were separated from recombinant human growth hormone (rhGH (1-191] by hydrophobic interaction chromatography (HIC). A proteolytically cleaved ('clip') form of rhGH which has a break in the polypeptide chain between Thr(142) and Tyr(143), also proved to be separable from rhGH by HIC. In addition, a mutated form of rhGH with only two amino acid substitutions, Glu(65) to Val(65) and Glu(66) to Lys(66), on a random coil domain of the molecule, was separated from rhGH by HIC, indicating that these substitutions altered the hydrophobicity of the molecule. Treatment of rhGH with hydrogen peroxide led to sulphoxide formation in two methionine residues Met(14) and Met(125); it was not possible to oxidize Met(170). The oxidized forms of rhGH were readily separated from rhGH(1-191) by reversed-phase chromatography. Analyses of rhGH batches showed very low levels (less than 0.3%) of oxidized rhGH, indicating that rhGH is highly resistant to oxidative reactions. Deamidations were induced in rhGH by heat treatment. The primary deamidation site was found to be Asn(149). Monodesamido rhGH and didesamido rhGH were efficiently separated from rhGH(1-191) by anion-exchange chromatography.

Chromatography, High Pressure Liquid

Isolation and characterization of a glycosylated form of human insulin-like growth factor I produced in Saccharomyces cerevisiae.

Expression and secretion of human insulin-like growth factor-I (IGF-I) in Saccharomyces cerevisiae was achieved by linking an actin (ACT) promoter to an MF alpha 1 prepro leader peptide/IGF-I gene fusion. Purified human IGF-I from yeast culture media was found to contain, in addition to the native form, also a glycosylated variant. Structural studies showed that both IGF-I forms were processed identically, resulting in 70-amino-acid long polypeptides, with intact N-terminal and C-terminal residues of glycine and alanine, respectively. The glycosylation site was determined to threonine-29 (Thr29), by 1H NMR spectroscopy and protein sequence analysis of an isolated tryptic peptide(22-36). No other glycosylation sites were found. Only mannose was detected in the sugar analysis, with an estimated content of 4.5% w/w corresponding to 2 mannose residues per molecule of IGF-I. The carbohydrate structure, determined by 1H and 13C NMR spectroscopy, was found to be alpha-D-Manp(1----2)alpha-D-Manp(1----3)Thr corresponding to an O-linked glycoprotein structure. No other post-translational modifications could be identified in the glycosylated IGF-I form. Furthermore, this form was highly active, comparable to native IGF-I, exhibiting a specific activity of 20,500 units/mg, as determined by a radio-receptor assay.

Actins

Aberrant eating behavior in elderly parkinsonian patients with and without dementia: analysis of video-recorded meals.

Aberrant eating behavior among 14 elderly, non-demented and 10 demented patients with Parkinson's disease was studied by means of video-recordings. The findings revealed problems in handling food on the plate, transporting food into the mouth, manipulating food in the mouth, and swallowing. Interpretations were performed based on impairments of autonomic processes, perception, cognition, emotion, and motor performance that occur in the disease.

Aged

Motor blockade and EMG recordings in epidural anaesthesia. A comparison between mepivacaine 2%, bupivacaine 0.5% and etidocaine 1.5%.

In a double-blind study young volunteers randomly received 20 ml of mepivacaine 2%, bupivacaine 0.5% or etidocaine 1.5% epidurally, all solutions with adrenaline. The mean cephalad spread of pin-prick analgesia was equal (T10) in the groups, but the duration was longest for bupivacaine and etidocaine. The motor blockade of the rectus abdominis muscles was assessed quantitatively by rectified integrated electromyographic recordings (RIEMG) and as number of turns in EMG recordings [changes in the direction (rise/fall) of the EMG; TURNS] from three different segmental levels, T7, T9 and T11. The motor blockade of the quadriceps muscles was estimated by EMG recordings simultaneously with muscle force measurements at maximal isometric knee extension. Motor blockade was also evaluated by the Bromage scale. There was good correlation (correlation coefficient 0.91) between RIEMG values and muscle force in knee extension during epidural anaesthesia. TURNS showed a non-linear relationship to isometric force during epidural anaesthesia and added no further information. At the lower parts of the abdomen (T11), etidocaine gave more profound and longer motor blockade than mepivacaine. For quadriceps muscle function, motor blockade was almost complete with all three local anaesthetics; the duration of maximum motor blockade was short (45-60 min) for mepivacaine, but about 5 h with etidocaine. At the time when the Bromage scale indicated complete regression of motor blockade, the muscle force of knee extension was only 30% and the quadriceps RIEMG 35% of control values and 1-3 h remained until the time of mobilization.(ABSTRACT TRUNCATED AT 250 WORDS)

Acetanilides

Motor and sensory blockade after epidural injection of mepivacaine, bupivacaine, and etidocaine--a double-blind study.

In a double-blind study of epidural anesthesia, 30 young volunteers were given either 2% mepivacaine (400 mg), 0.5% bupivacaine (100 mg), or 1.5% etidocaine (300 mg), all solutions containing epinephrine (1:200,000). The spread of analgesia was equal in the groups, whereas the longest duration was noted in the etidocaine and bupivacaine groups. With use of a method for determining muscle force, motor blockade during anesthesia was recorded quantitatively for hip flexion, knee extension, and plantar flexion of the big toe. Onset of motor blockade was significantly more rapid with etidocaine than with bupivacaine and mepivacaine. All subjects given etidocaine developed complete motor blockade, but with the other local anesthetics 5%-33% of the initial muscle force remained. The least motor blockade was found in the L5-S2 segment (plantar flexion of the big toe). The duration of maximal motor blockade varied between 60 min (mepivacaine) and 360 min (etidocaine). With each of the three local anesthetics, motor function returned simultaneously in the three muscle groups tested. Complete restoration of muscle function occurred significantly later for etidocaine (600 min) than for bupivacaine (360 min) and mepivacaine (180 min). With etidocaine, the motor blockade outlasted the sensory blockade by 150 min. The Bromage scale corresponded to the motor blockade only during the first half of the regression phase. Not until 1-3 h after attainment of Bromage grade 0 was the muscle force of all movements restored (90% of control values).

Acetanilides

Eating problems and nutritional status during hospital stay of patients with severe stroke.

Eating problems and nutritional status were studied in a consecutive series of patients who had had strokes. From this cohort, 32 subjects (mean age 73 years) with a hospital stay of 21 days or more are described. Eating problems were identified by direct participant observations of the patients' eating behavior, interviews on admission, inspections of the mouth, and discussions with the patients. Nutritional status was assessed by weight, triceps skinfold thickness (TSF), arm muscular circumference (AMC), plasma albumin, serum transferrin, and plasma prealbumin on admission and then weekly. Eating problems were identified in 27 patients. In a general linear hypothesis program, poor nutritional status 3 weeks after admission was found to be associated with (in decreasing order) low self-care performance, poor nutritional status on admission, male sex, intravenous energy-containing fluids, advanced age, paresis of the right arm, and eating problems. Factors other than eating problems seem to be important for undernutrition in patients with strokes during hospital stay.

Cerebrovascular Disorders

Nutritional status in patients with acute stroke.

By measuring three anthropometric variables (relative weight, triceps skinfold thickness and arm muscle circumference) and three circulating proteins (albumin, transferrin and prealbumin), nutritional status was assessed in 100 consecutive patients with acute stroke. On admission to hospital, two or more indicators showed subnormal values for 16%; this was associated with the female sex, high age and a history of atrial fibrillation. At discharge, 22% had two or more subnormal indicators. Poor nutritional status during the hospital stay appeared to be related to infections, the male sex, the intake of cardiovascular drugs and high age. Fewer of the patients with two or more subnormal nutritional indicators were able to return home than of the patients with none or one subnormal nutritional indicator. We conclude that undernutrition is not uncommon at the onset of stroke and that certain risk groups for the development of undernutrition during hospital stay can be identified.

Acute Disease

Venous blood concentration of lidocaine after nasopharyngeal application of 2% lidocaine gel.

In 34 subjects undergoing topical anaesthesia with lidocaine gel (2% xylocaine gel), the concentrations of lidocaine base were measured in repeated venous blood samples. Twenty-three patients (Group I) were given 20 ml of 2% lidocaine gel (400 mg of lidocaine) and six subjects (Group II) 40 ml of 2% lidocaine gel (800 mg of lidocaine) nasopharyngeally, the gel reaching the pharynx being swallowed. Five minutes after administration of the gel, a gastric tube was introduced via the nasal cavity. In six patients (Group III), the bladder was catheterised in addition to insertion of a gastric tube. Before the catheter was introduced, these patients were given lidocaine gel nasopharyngeally (400 mg) and endourethrally (400 mg). After the introduction of the gastric tube, all subjects (except four volunteers in Group II) were given general anaesthesia. Before intubation, the patients in Group III also received lidocaine spray laryngotracheally (50 mg; 10% xylocaine spray). The initial absorption of lidocaine was rapid, although the blood concentrations were low. The mean peak concentrations (Cmax) of lidocaine in the three groups were 0.57, 1.39 and 0.73 micrograms/ml, respectively. The blood concentration in Group II was significantly higher than those in Groups I and III. The mean length of time between the nasopharyngeal application of lidocaine gel and the time when Cmax was reached (tpeak) was the same in all three groups (60-70 min).(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Inhalation

Evaluation of motor blockade by isometric force measurement and electromyographic recording during epidural anaesthesia--a methodological study.

Methods for assessing motor blockade by means of isometric force measurements and surface electromyographic (EMG) recordings in the lower extremities and abdominal wall were evaluated in 30 volunteers. The coefficients of variation were 10% for force measurements and 14% and 20% for average rectified EMG (RIEMG) recordings over the quadriceps muscle and abdominal muscles, respectively, and 8% overall for TURNS (the number of changes in the sign of the direction of the EMG signal). Seven of the 30 volunteers received epidural anaesthesia with 20 ml of mepivacaine 2% with adrenaline. The mean maximal cephalad analgesic level was T9. At that abdominal segment, RIEMG showed a reduction of 50% and TURNS of 20%. Isometric force and RIEMG recorded simultaneously in the quadriceps muscles during epidural anaesthesia displayed a linear relationship with a correlation coefficient of 0.91. TURNS was insensitive to force variations above 60% of maximum voluntary contraction. During the regression phase, 90% of both the initial force and RIEMG value was noted 180 min after the epidural injection. It is concluded that recording of RIEMG is a good method for quantitative assessment of motor blockade during epidural anaesthesia.

Abdominal Muscles

In vivo production of thromboxane and prostacyclin in patients following total hip arthroplasty.

The in vivo production of thromboxane and prostacyclin was studied by measurements of their major urinary metabolites in eight patients undergoing total hip arthroplasty. Specific methods based on gas chromatography-mass spectrometry were used to measure the urinary excretion of 2,3-dinor-TxB2 and 2,3-dinor-6-keto-PGF1 alpha. The excretion of these metabolites increased about 10-fold during the intra and immediate postoperative period and 4 days after surgery was still higher than during the preoperative period. The increased thromboxane formation reflects probable activation of platelets whereas the increased prostacyclin could be part of a vascular defense against induced thrombotic activity. These findings may have pathophysiological implications.

6-Ketoprostaglandin F1 alpha