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Biomedical subjects

K Axelsson

Publications and source records attributed to K Axelsson.

At least 73 records · Page 4Linked to original sources
PubMed1986

Relearning to eat late after a stroke by systematic nursing intervention: a case report.

Using a training programme developed by Heimlich, we have attempted to train swallowing in a 78-year-old man who had been fed by a nasogastric tube for 3 years after a stroke. The training was successful and, during a follow-up of 1 year, the patient was eating normal food. The training process is analysed as a two-level communication between the patient and his trainer; the therapeutic relationship and the training programme. The development of the patient's attitudes during training is interpreted with reference to Erikson's theory of 'eight stages of man'.

Activities of Daily Living↗
PubMed1985

A new method for measuring motor block in the lower extremities.

A method for determining muscle strength in the lower extremities was developed and its clinical application evaluated in ten elderly, healthy subjects, and also subsequently in one of them during spinal anaesthesia. With the subject lying in the lithotomy position on a modified operating table, muscle strength measurements were made during flexion of the hip, extension of the knee and plantar flexion of the big toe. The electromechanical performance of the apparatus was stable, and the maximum measurement errors observed at loads of 245 and 49 N were 4 and 11% of the deflections, respectively. The subjects underwent repeated muscle strength measurements during a 4-h period without any difficulty. No signs of muscular fatigue were observed. The variation of the measured isometric muscle strength was small and the average coefficient of variation roughly 10%. In the patient receiving spinal anaesthesia, the degree of motor block was determined, and the results are presented graphically. This new method for evaluation of motor block in the lower extremities is a reliable quantitative method for bilateral, three-joint muscle strength measurements, which is also applicable during regional anaesthesia.

Aged↗
PubMed1985

A comparison of bupivacaine and tetracaine in spinal anaesthesia with special reference to motor block.

Thirty-six patients received spinal anesthesia with either glucose-free bupivacaine (22.5 mg) or glucose-containing solutions of bupivacaine (20 mg) or tetracaine (15 mg). The duration of analgesia in the lower thoracic and lumbar segments was significantly longer with glucose-free bupivacaine than with the other solutions. Using a quantitative method for measuring muscle strength, the motor block was recorded for three types of movements: hip flexion, knee extension and plantar flexion of the big toe. Movements of the lower part of the thoracic cage were recorded at the same time. The length of time from spinal injection to complete motor block was short and without notable difference between all three groups. Regression of the motor block tended to start earlier for hip flexion and knee extension than for plantar flexion of the big toe. For all three movements the regression of the motor block began significantly later in the glucose-free bupivacaine group than in the other groups. During the regression phase, muscle strength returned significantly later in the glucose-free bupivacaine group than in the bupivacaine group containing glucose and knee extension returned significantly later in the glucose-free bupivacaine group than in the tetracaine group. No difference in motor block was found between the hyperbaric solutions of bupivacaine and tetracaine. For hip flexion (L1-L3), there was no noteworthy difference between the level of analgesia and the motor block segments, whereas for plantar flexion of the big toe (L5-S2) the level of analgesia lay 2-3 segments higher than the motor block segments. In seven patients, during spinal anaesthesia there was a reduction in respiratory deflections corresponding to the lower thorax.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1985

Bladder function in spinal anaesthesia.

Spinal anaesthesia with bupivacaine (22.5 mg) or with a glucose-containing solution of bupivacaine (20 mg) or tetracaine (15 mg) was given to 21 patients allocated randomly to these three groups. A urodynamic study was performed by CO2 cystometry. It consisted of recording of first sensation of bladder filling, sensation of full bladder, strength of maximal detrusor contraction, bladder capacity and urethral pressure. At the same time, using a quantitative method for measuring muscle strength, the motor block was evaluated for three separate movements--hip flexion, knee extension and plantar flexion of the big toe. After the spinal injection, the micturition reflex was rapidly blocked. One minute after the injection, eight patients experienced no strong desire to void when the bladder was overfilled, and 5 min after the injection bladder paralysis was present in most patients. The length of time from spinal injection to complete recovery of detrusor strength was 7-8 h and did not differ significantly between the three groups. The level of analgesia lay at or caudal to L5 when the detrusor strength returned. On the average, sensibility (pin-prick) in the sacral segments returned simultaneously with or somewhat earlier than complete recovery of detrusor strength. The muscle strength in the lower limbs was fully restored 40-140 min, on average, before the detrusor strength had completely recovered. There was good correlation between the time of full restoration of hip flexion and detrusor strength in the bupivacaine groups. Urethral pressure was reduced by a mean of 48% and returned to normal either at the same time as or slightly before complete recovery of detrusor strength.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1983

Relative contributions of thioltransferase-and thioredoxin-dependent systems in reduction of low-molecular-mass and protein disulphides.

Two enzyme systems capable of reducing disulphide bonds both in low-Mr compounds and in polypeptides and proteins exist. One consists of thioltransferase in combination with reduced glutathione and glutathione reductase, and the second consists of thioredoxin in combination with thioredoxin reductase. Their relative effectiveness in catalysing disulphide reduction of various substrates in rat liver cytosol was evaluated in the present study. The thioltransferase-dependent system was found to be more efficient in reducing small molecules. Insulin was most effectively reduced by the thioredoxin system. Bovine trypsin was a better substrate for thioltransferase, and partially proteolysed bovine serum albumin was equally good for the two systems. Thus, in the case of protein disulphide bonds, the nature of the particular substrate used determines which of the two reducing systems is the more important.

Animals↗
PubMed1983

An essential role of cytosolic thioltransferase in protection of pyruvate kinase from rabbit liver against oxidative inactivation.

Pyruvate kinase from rabbit liver is inactivated spontaneously in the presence of air. Glutathione in physiological concentrations gives partial protection against inactivation. Full protection is obtained with glutathione and purified cytosolic thioltransferase supplemented with a glutathione-regenerating system. It is suggested that thioltransferase plus glutathione serve a general function in protecting protein thiol groups against oxidation.

Animals↗
PubMed1983

Blood concentration of lignocaine after application of 2% lignocaine gel in the urethra.

In 35 patients undergoing topical anaesthesia with lignocaine (lidocaine) gel (2% Xylocaine gel) the concentration of lignocaine base was measured in repeated venous blood samples. Twenty patients (group I) were given 20 ml of 2% lignocaine gel (400 mg lignocaine) and 5 patients (group II) received 40 ml (800 mg lignocaine) endourethrally. These 2 groups of patients underwent either dilation of the urethra or urethrocystoscopy. Ten patients (group III) undergoing transurethral resection of the prostate or a bladder tumour, were given 20 ml of gel (400 mg lignocaine) plus spinal anaesthesia with 2 ml of 5% lignocaine (100 mg lignocaine) with 7.5% glucose (Xylocaine "heavy"). The mean peak blood concentrations of lignocaine in these 3 groups were 0.06, 0.15 and 0.36 micrograms/ml respectively. Patients undergoing urethral dilatation had significantly higher blood concentrations than cystoscopy patients. The blood concentrations in group III were not higher than the expected value when spinal anaesthesia and lignocaine gel were given simultaneously. There was no statistically significant difference in the blood concentration between patients undergoing different types of transurethral resection (prostate and cancer of the bladder). Lignocaine applied endourethrally gives an extremely low blood concentration which is far below the level which can cause general toxic symptoms.

Administration, Topical↗
PubMed1983

[Morning toilet].

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Activities of Daily Living↗
PubMed1983

An experimental study of urodynamic effects of epidural morphine and of naloxone reversal.

Urinary retention after epidural morphine is a distressing and troublesome complication. This study was undertaken to determine the effects of morphine (epidural, intramuscular, and intravenous) on urinary bladder function and possible reversal by naloxone. Thirty male volunteers (aged 20-28 years) were studied; the doses studied were 2, 4, and 10 mg of epidural morphine, 10 mg intramuscular morphine, and 10 mg intravenous morphine. The urodynamic study consisted of measurements of urine flow rate, strength of detrusor contraction, bladder capacity, and urethral pressure. Irrespective of dose, all subjects receiving epidural morphine showed marked relaxation of the detrusor shortly after injection. There was a corresponding increase in the maximal bladder capacity leading to urinary retention. These effects lasted an average of 14-16 h. Urethral pressures remained unchanged. Urodynamic changes after intramuscular and intravenous morphine were minimal. Treatment using a single intravenous injection of 0.8 mg naloxone promptly reversed the effects of epidural morphine on the bladder. Prevention of urinary retention was achieved with an intravenous infusion of naloxone started before administration of epidural morphine. The possible mechanisms of urinary retention following epidural opiates are discussed.

Adult↗
PubMed1981

Blood concentration of lidocaine after spinal anaesthesia using lidocaine and lidocaine with adrenaline.

In 32 patients undergoing spinal anaesthesia with lidocaine or lidocaine plus adrenaline, the concentration of lidocaine base was measured in repeated venous blood samples. Half of the patients were given 100 mg lidocaine alone and the other half 100 mg lidocaine with the addition of 0.2 mg adrenaline. The blood concentration of lidocaine was significantly higher in the lidocaine group than in the group that received lidocaine with adrenaline. The mean maximal concentrations in these two groups lay between 0.2 and 0.3 and between 0.1 and 0.2 micrograms/ml, respectively (P less than 0.01). The time required for the individual maximal concentration to be reached was independent of whether the anaesthetic contained adrenaline or not. The blood concentration showed no correlation to body weight, height, or body surface area. In the first 60 min after the spinal injection the extent of the sensory block was the same in the two groups, but at 120 min this extent was significantly greater in the lidocaine-adrenaline group (P less than 0.01). The results show that the blood concentration of lidocaine is low in spinal anaesthesia compared with other types of regional anaesthesia.

Aged↗
PubMed1980

Role of cytoplasmic thioltransferase in cellular regulation by thiol-disulphide interchange.

Cytoplasmic thioltransferase purified from rat liver [Axelsson, Eriksson & Mannervik (1978) Biochemistry 17, 2978--2984] catalyses the formation and decomposition of mixed disulphides of proteins and glutathione. The enzyme was found to catalyse the reversible thiol-disulphide interchange between glutathione disulphide and a crude thiol-containing protein fraction from rat liver. This finding indicates a role of the thioltransferase in the regulation of the 'glutathione status' of the cell. Specifically, it was found that thioltransferase catalyses the reactivation of pyruvate kinase from rat liver that had previously been inactivated by glutathione disulphide. It is suggested that thioltransferase may have a general role in regulatory processes involving thiol-disulphide interchange.

Animals↗
PubMed1980

General specificity of cytoplasmic thioltransferase (thiol:disulfide oxidoreductase) from rat liver for thiol and disulfide substrates.

The substrate specificity of thioltransferase (thiol:disulfide oxidoreductase) purified from rat liver cytosol (Axelsson, K., Eriksson, S. and Mannervik, B. (1978) Biochemistry 17, 2978-2984) has been investigated. Various low-molecular-weight thiols were found to be substrates in the scission of sulfur-sulfur bonds in cystamine and glutathione disulfide as well as in mixed disulfides of proteins and glutathione. Protein sulfhydryl groups could also serve as thiol substrates in enzyme-catalyzed thiol-disulfide interchange. Thiol-transferase also catalyzed the reduction of sulfur-sulfur bonds in disulfide-containing proteins by glutathione provided that the proteins had been denatured by proteolysis or urea treatment. It is proposed that thioltransferase may have a role in the intracellular protein degradation by cleavage of disulfide bonds. The finding that thioltransferase catalyzes the reversible formation of mixed disulfides of glutathione and the bulk of proteins in rat liver cytosol is relevant for the catalysis of changes in the 'glutathione status' in the cell. In conclusion, the results of the present investigation show that cytoplasmic thiol-transferase has a very broad substrate specificity, which implies that the enzyme may participate in a multitude of thiol-disulfide interchange reactions.

Animals↗