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Biomedical subjects

K Johansen

Publications and source records attributed to K Johansen.

At least 181 records · Page 10Linked to original sources
PubMed1982

Thyroid stimulating antibodies, thyroglobulin antibodies and serum proteins during treatment of Graves' disease with radioiodine or propylthiouracil.

The relation between serum concentrations of thyroglobulin antibodies (TgAb), thyroid-stimulating antibodies (TSAb) and serum immunoglobulins during treatment of Graves' disease was studied in 36 consecutive patients treated randomly with 131-iodine (n = 16) or propylthiouracil (n = 20). The patients were investigated before treatment was started and on seven occasions within the following year. In the entire patient group 78% were positive for TSAb and 47% for TgAb. There was a significant correlation between TSAb and TgAb in 15 patients concomitantly positive. There were no significant changes in serum immunoglobulins during treatment in either group of patients. In the radioiodine-treated group of patients TgAb was reduced after 1 week, whereas TSAb showed insignificant variations. After 5-10 weeks both antibodies increased, for TgAb with a median peak level 3 time above the initial concentration. Of 16 patients treated with radioiodine five developed myxoedema and four of these were positive for TgAb. There was a relation between the development of myxoedema and the ratio between increases of TSAb and TgAb. Increase in TSAb was not related to serum thyroglobulin (Tg) measured in TgAb-negative patients. Propylthiouracil showed minor effects on the studied variables, but with lower mean values of Tg, TgAb and TSAb at the end of the observation period. The results indicate an immunological relation between TSAb and TgAb, although differences between their course exist in some situations.

Adult↗
PubMed1982

A prospective study of the differential changes in serum thyroglobulin and its autoantibodies during propylthiouracil or radioiodine therapy of patients with Graves' disease.

Measurement of serum thyroglobulin (Tg) and its autoantibody (TgAb) by radioimmunological methods was performed in 48 patients with Graves' disease during treatment with radioiodine (n = 16) or propylthiouracil (PTU) (n = 32). Twenty-five of the 48 patients were TgAb positive, their sera being inaccessible to measurement of serum Tg. TgAb showed only minor changes during PTU treatment, whereas TgAb fell rapidly after radioiodine, in 5 of 16 patients to unmeasurable levels, followed by a secondary rise to 4.5 times pre-treatment level after 20 weeks. Serum Tg showed a steady increase during the first weeks after radioiodine treatment, but fell to lower levels after one year. PTU caused only minor changes in the serum Tg concentration. There was no shift in molecular sizes of either Tg or TgAb during the course of the treatments. Five of 16 131I-treated patients developed myxoedema, 4 of whom were TgAb positive. Another 3 patients had high increases in TgAb without myxoedema. Six of 18 patients had relapse of thyrotoxicosis after withdrawal of PTU-treatment. There was no significant difference in serum concentrations of TgAb or Tg between those developing relapse and those remaining in remission, and it is concluded that serum Tg is a poor predictor of relapse in medically treated thyrotoxicosis.

Adult↗
PubMed1982

131I treatment of diffuse and nodular toxic goitre with or without antithyroid agents.

The results of 131I treatment in combination with pre- and post-treatment with carbimazole (n = 122) were compared to the results of 131I used as the only antithyroid treatment (n = 203). The two groups of patients were fully comparable in regard to age, size of goitre and time of observation, and the same diagnostic criteria and dosage regimen of 131I were used. The incidence of early myxoedema in patients with diffuse goitre was significantly reduced after combination therapy, 5 per cent, compared to 16 per cent after 131I as the only antithyroid therapy (P less than 0.05). The incidence of late myxoedema was 6 per cent in both groups 3 years after the last treatment, and fully compensated myxoedema was found in 13 and 22 per cent (n.s.). No severe acute side effects were observed after 131I therapy in any of the two groups. It is concluded that--in diffuse toxic goitre--a lower early incidence of myxoedema was obtained on the combined regimen because of either a possibly lower absorbed radiation dose or a more fractionate therapy. A major advantage of the combination therapy is also, that the patients are rendered euthyroid shortly after the diagnosis and remain so during the prolonged period of treatment. 131I treatment in combination with carbimazole is advocated in all patients with diffuse and nodular toxic goitre if the patient is above fertile age and thyroidectomy is not indicated.

Adenoma↗
PubMed1982

Nasogastric tube displacement in acute traumatic rupture of the thoracic aorta: a postmortem study.

Acute traumatic rupture of the thoracic aorta is an often fatal deceleration injury with only 15%--20% of victims surviving to receive emergency treatment. Numerous chest radiographic findings associated with this injury have been reported, but all are nonspecific. Nasogastric tube deviation to the right has been recently described in two series as a more sensitive and specific sign of aortic rupture, said to be present in 92.8% with rupture and in none with normal thoracic aortas. In this study of eight victims of fatal motor vehicle accidents with documented aortic rupture, five (62.5%) had nasogastric tube deviation to the right and three (37.5%) had deviation to the left. This supports other reported clinical experience suggesting that rightward nasogastric tube deviation in only 60%--70% sensitive for aortic rupture. Thus, absence of nasogastric tube deviation to the right does not exclude the diagnosis of aortic rupture, and decision-making regarding aortography must be based on other clinical and radiologic criteria.

Accidents, Traffic↗
PubMed1982

Left-sided portal hypertension from pancreatic pseudotumor.

Involvement of the splenic venous outflow tract by pancreatic disease can cause localized splenic venous hypertension and esophageal varices. Resolution of this problem resides in splenectomy and distal pancreatectomy or perhaps splenectomy alone. Although this phenomenon most commonly arises from thrombosis of the splenic vein by adjacent pancreatitis, we report a case arising from nonocclusive obstruction of the splenic vein by an adjacent pancreatic pseudotumor.

Adult↗
PubMed1981

Acute bilateral renal artery occlusion. Revascularization with the splenic artery.

Although acute renal artery occlusion usually leads to kidney necrosis, preexisting collateral vessels may occasionally preserve the organ long enough to permit revascularization. This principle was demonstrated in a patient in whom bilateral acute renal artery occlusion developed following repair of an aortoduodenal fistula. Approach to the aorta for primary revascularization was interdicted by extensive scarring. Accordingly, bilateral renal artery revascularization was successfully effected with the use of the splenic artery and reversed saphenous vein grafts through extra-anatomic planes. This experience demonstrates the importance of an aggressive diagnostic and therapeutic approach to acute renal artery occlusion, as well as the usefulness of the large-caliber, lengthy, disease-free, dispensable splenic artery as a revascularization source.

Humans↗
PubMed1981

The relative importance of skin oxygen uptake in the naturally buried plaice, Pleuronectes platessa, exposed to graded hypoxia.

Cutaneous O2-uptake has been estimated in plaice, Pleuronectes platessa, naturally buried in sediment as the difference between total O2-uptake, measured in a flow-through respirometer, and branchial O2-uptake calculated from direct and continuous recordings of gill water flow and O2-extraction from the ventilatory current. At conditions of aerated water cutaneous O2-uptake made up 27% of total uptake. During exposure to hypoxic water, cutaneous O2-uptake declined less than O2-uptake across the gills. Hence the relative importance of cutaneous O2-uptake increased with progressive hypoxia, making up 37% of total at a water PO2 of 40 mm Hg. Factors are discussed which may affect the level of cutaneous O2-uptake at changing conditions of ambient O2-availability.

Animals↗
PubMed1981

Gill O2 consumption in a teleost fish, Gadus morhua.

Stimulated by the many physiological functions of fish gills this study reports on perfusion studies of gill arches and head preparations from the Atlantic cod, Gadus morhua, with the objective of determining the oxygen requirement of gill tissues in situ. An additional objective was to assess what fraction of the gill tissue O2 consumption is taken up directly from ambient water without intervention of internal gill perfusion. At 15 degrees C and air-saturated ambient water about 58% of the total gill O2 requirement was taken up from the perfusate while 42% entered gill tissues directly from ambient water. In relation to total O2 uptake of intact cod fish the gill tissue requires 6.65% giving gill tissues a weight-specific O2 requirement of 95.2 microliter O2 . g body wt-1 . h-1 or nearly twice that of the intact fish (54.5 microliter O2 . g body wt-1 . h-1). It is discussed how the gill tissue O2 requirement influences the employment of the Fick principle for calculations of cardiac output in fishes.

Animals↗
PubMed1981

The significance of the linkage between the Bohr and Haldane effects in cephalopod bloods.

This study concerns the physiological implications of the theoretical identity between the Bohr and Haldane effects in the hemocyanin containing blood from the cephalopods Loligo forbesii and Sepia officinalis. The Bohr factor is for both species lower than -1.0. The functional Haldane coefficient (delta ctCO2/delta cHcO2)pH ranges from -2.0 to -0.9 mMCO2/mMO2 in S. officinalis and from -1.2 to -0.7 mMCO2/mMO2 in L. forbesii. This implies for S. officinalis that there may not be enough protons produced from aerobic metabolism to facilitate the release of O2 from HcO2 via the pH sensitivity of this binding. The amount of anaerobically produced protons are predictably of little consequence for release of Hc bound O2 in cephalopods since octopine as the primary product of anaerobic metabolism is a much weaker acid than lactic acid at physiological pH. It is proposed that during burst swimming powered by the ventilatory current, such as practiced by many squids, the overall requirement for ventilation may increase causing a reduced pCO2 and bring the functional Haldane effect below unity. This implies that more H+ are produced by aerobic metabolism than can be found to hemocyanin, hence a shift of the O2 equilibrium curve to the right and improved O2 unloading potential. The advantage of the very large (pH sensitivity) Bohr shift in benthic forms like S. officinalis, both tolerant of and frequently experiencing hypoxic water, may rest with a marked increase in O2 affinity and improved O2 loading in response to respiratory alkalosis produced by hyperventilation.

Animals↗
PubMed1981

Pulmonary diffusing capacity of the bullfrog (Rana catesbeiana).

Carbon monoxide diffusing capacity of the lungs (DLCO) was measured in bullfrogs, Rana catesbeiana (mean body weight 260 g) along with oxygen uptake, pulmonary perfusion and lung volume. The measurements were all performed by methods depending on mass-spectrometry. Pulmonary oxygen uptake, DLCO and perfusion all increased with body temperature. At 20 degrees C O2-uptake was 0.49 ml STPD . kg-1 . min-1 at rest and DLCO was 0.022 ml STPD . kg-1 . min-1 . Torr-1. At 30 degrees C the values for O2-uptake and DLCO approximately doubled. Lung volume was large (90 ml . kg-1) and independent of body temperature. Oxygen uptake and DLCO of the bullfrog were small compared to values for a similar-sized mammal but the ratios of DLCO to O2-uptake quite similar. Analysis of available data on DLCO and O2-uptake in ectotherms also suggests a close correlation between O2-uptake and DLCO.

Animals↗
PubMed1981

Acid-base regulation during heating and cooling in the lizard, Varanus exanthematicus.

Current concepts of acid-base balance in ectothermic animals require that arterial pH vary inversely with body temperature in order to maintain a constant OH-/H+ and constant net charge on proteins. The present study evaluates acid-base regulation in Varanus exanthematicus under various regimes of heating and cooling between 15 and 38 degrees C. Arterial blood was sampled during heating and cooling at various rates, using restrained and unrestrained animals with and without face masks. Arterial pH was found to have a small temperature dependence, i.e., pH = 7.66--0.005 (T). The slope (dpH/dT = -0.005), while significantly greater than zero (P less than 0.05), is much less than that required for a constant OH-/H+ or a constant imidazole alphastat (dpH/dT congruent to 0.018). The physiological mechanism that distinguishes this species from most other ectotherms is the presence of a ventilatory response to temperature-induced changes in CO2 production and O2 uptake, i.e., VE/VO2 is constant. This results in a constant O2 extraction and arterial saturation (approx. 90%), which is adaptive to the high aerobic requirements of this species.

Acid-Base Equilibrium↗
PubMed1981

Decreased urinary glucose excretion and plasma cholesterol level in non-insulin dependent diabetic patients with guar.

The effect of guar gum in lowering urinary glucose excretion and plasma cholesterol was studied in ten sulphonylurea-treated non-insulin dependent diabetic patients during a four week treatment period. The 24-hour urinary glucose excretion fell gradually and increased again to pretreatment value after withdrawal of guar. The glucose output dropped by 33 and 51% in the 3rd and 4th week of the guar treatment period (p less than 0.01) compared to the mean of the pre-plus postguar level. The plasma cholesterol concentration also fell significantly during treatment with guar (p less than 0.01).

Aged↗
PubMed1981

Improvement of amputation level by lower extremity revascularization.

Improvement of amputation level, with a resulting increase in the ambulatory rehabilitation potential, was achieved in ten patients requiring extirpation of the lower extremity because of gangrene. Arterial reconstruction, percutaneous transluminal dilation or chemical lumbar sympathectomy, or a combination of these modalities, was used to achieve primary healing at an amputation site at least one level below that initially suggested by clinical and noninvasive diagnostic means. Patients requiring amputation of the lower extremity who are good candidates for ambulatory rehabilitation should undergo an aggressive diagnostic and therapeutic search for treatable proximal arterial lesions, thereby preserving limb length and increasing the likelihood of independent prosthetic use.

Amputation, Surgical↗