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Biomedical subjects

K Ström

Publications and source records attributed to K Ström.

34 records · Page 2Linked to original sources
PubMed1993

Analysis of lipoprotein diene formation in human serum exposed to copper.

The susceptibility of low density lipoprotein (LDL) to oxidative modification can be determined by analyzing the lag phase for initiation of diene formation in isolated LDL exposed to Cu2+. However, the applicability of this assay for clinical studies is limited by the requirement of a preparative ultracentrifugation of LDL and that the influence of water soluble antioxidants and other lipoproteins is not accounted for. The present paper describes a modification of this assay allowing determination of lag phase for lipoprotein diene formation in serum. The formation of dienes in serum exposed to Cu2+ begins following the consumption of serum alpha-tocopherol, correlates to the formation of thiobarbituric acid reactive substances (r = 0.987, n = 8), is inhibited by the addition of ascorbic acid and is absent in lipoprotein-deficient serum. It is also accompanied by an increased mobility of serum lipoproteins on agarose gel electrophoresis and with an ability of serum to displace isolated copper-oxidized LDL from binding sites mediating degradation in mouse peritoneal macrophages. The coefficient of variance of the analysis is below 3%. It is concluded that this technique allows analysis of lipoprotein oxidation susceptibility in serum samples and may prove to be useful in clinical analysis of the lipoprotein oxidation susceptibility.

Animals↗
PubMed1993

Long-term oxygen therapy in parenchymal lung diseases: an analysis of survival. The Swedish Society of Chest Medicine.

We have analysed the predictors of survival in patients starting long-term domiciliary oxygen therapy (LTO) for chronic hypoxia caused by parenchymal lung disease. In 240 patients (136 males) LTO was started at a mean age of 70 yrs. Survivors have been followed up for a minimum of 28 months (range 28-57 months). Interstitial fibrosis was the sole cause of hypoxia in 51 patients, and late sequelae of pulmonary tuberculosis in 48 patients. More than one (mixed) disease caused hypoxia in 124 patients. Patients with tuberculosis (TB) started LTO with significantly higher values of arterial carbon dioxide tension (PaCO2) and markedly lower spirometry volumes than patients with interstitial fibrosis. In the total patient group survival was correlated in the univariate analysis to cause(s) of hypoxia, performance status and PaCO2 when breathing air. TB had a relatively good prognosis, whilst interstitial fibrosis implied a poor long-term survival. A PaCO2 of below 5.5 kPa and a poor performance class was associated with increased mortality rates. In TB patients, survival was better when thoracic deformity contributed to hypoxia. In patients with interstitial fibrosis, a forced vital capacity of below 2.1 l was associated with increased mortality. Concomitant chronic obstructive pulmonary disease was associated with better survival than interstitial fibrosis alone. In the multivariate analysis, survival was found correlated to performance status, presence or absence of thoracic deformity and forced expiratory volume in one second (FEV1) and forced vital capacity (FVC).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1992

Respiratory failure in scoliosis and other thoracic deformities. A survey of patients with home oxygen or ventilator therapy in Sweden.

Registers covering Swedish patients with home ventilator or long-term oxygen therapy were used to study respiratory failure caused by thoracic deformities. In all, 107 patients were studied. Postpolio scoliosis was found in 47 patients. The age of starting therapy varied between 28 and 80 years. Fourteen patients had thoracic deformities other than scoliosis. The mean scoliotic angle was 135 degrees among the patients with scoliosis, and the mean vital capacity was 26% (range, 13-54%) of predicted normal. The yearly demand for home ventilator or oxygen therapy is calculated to three per million inhabitants. No operated patients had respiratory failure, and no patients were found with idiopathic scoliosis and respiratory failure younger than 30 years of age, which may indicate a preventive effect of corrective surgery on the development of respiratory failure.

Aged↗
PubMed1992

Survival of patients with severe thoracic spine deformities receiving domiciliary oxygen therapy.

Scoliosis can lead to respiratory failure and premature death. Alveolar hypoventilation is a dominant cause and artificial ventilation at home (AVH) is probably the treatment of choice. It has been suggested that long-term domiciliary oxygen therapy (LTO) is of little value because of the worsening of hypercapnia. We analyzed survival and predictors of death among 80 patients with scoliosis and other severe thoracic spine deformities receiving LTO for chronic hypoxia. The survival rate was higher in patients under the age of 65 (p = 0.01) and in patients without concomitant pulmonary or airways disease. Likewise, the survival rate was higher in patients with a PaCO2 of greater than 7.4 kPa than in patients with a lesser degree of hypoventilation and hypercapnia (p less than 0.05). The risk of developing life-threatening hypercapnia during well-controlled LTO appeared to be small. In younger patients without complicating disease, long-term survival was achieved with LTO, but with time, an increasing proportion of the patients changed to AVH, with or without LTO.

Aged↗
PubMed1991

S-erythropoietin levels decrease in patients with chronic hypoxia starting domiciliary oxygen therapy.

Consecutive determinations of erythropoietin in serum (s-Epo) were made in ten patients with chronic hypoxia starting domiciliary long-term oxygen therapy (LTO). After 24 h of supplementary oxygen treatment there was a fall in the median s-Epo level from 11.3 to 4.4 IU.l-1 (p less than 0.01). The initial decrease in s-Epo in conjunction with oxygen treatment was not sustained after one and three months of LTO. S-Epo levels above the reference range (3.3-13.5 IU.l-1) were found in three patients before and during LTO and in another two patients during LTO. Markedly elevated s-Epo levels were found in two patients with hypoxia and hypercapnia at the time of blood sampling. A significant negative relationship was found between the arterial oxygen tension and the log value for the s-Epo level (r = 0.40, p less than 0.005). The s-Epo levels were found to be normal in half of the measurements in patients using oxygen less than 15 h daily, a fact that indicates that s-Epo measurements are probably not suitable as indicators of compliance with LTO.

Aged↗
PubMed1991

Quality assessment and predictors of survival in long-term domiciliary oxygen therapy. The Swedish Society of Chest Medicine.

On January 1, 1987, 560 patients (267 male) were registered as using long-term domiciliary oxygen therapy (LTO) in Sweden. The duration of LTO before this date varied between 10 days and 11 yrs. During a two-year follow-up 12 patients had their LTO withdrawn because they were no longer hypoxic. In 139 patients the arterial oxygen tension (PaO2) on breathing air was registered three times. In seventeen (12%) of these patients the PaO2 exceeded 7.5 kPa on all three control occasions. The two year actuarial survival in all patients was 57%. The two year actuarial survival was 77% in patients with kyphoscoliosis, 56% in patients with sequelae of tuberculosis, 54% in patients with chronic obstructive pulmonary disease (COPD) and 39% in patients with fibrosis. In COPD patients survival was predicted by age, sex, current smoking habits, arterial carbon dioxide tension (PacO2) when breathing oxygen and oral steroid medication. A poor Zubrod performance score was associated with a high mortality rate in all patient groups.

Actuarial Analysis↗
PubMed1988

A national register for long-term oxygen therapy in chronic hypoxia: preliminary results.

A national register of patients undergoing long-term oxygen therapy in Sweden was started in 1987. Of the population of 8.4 million, 560 patients (267 males) were registered as undergoing domiciliary oxygen treatment on January 1, 1987. These registered patients, aged between 2-86 yrs (mean age 65 yrs), constituted some 90% of all patients receiving domiciliary oxygen therapy because of chronic hypoxaemia on that date. The chronic respiratory diseases leading to hypoxaemia (more than one diagnosis could be registered for each patient) were: chronic obstructive pulmonary disease (COPD) (393), sequelae from pulmonary tuberculosis (92), thoracic deformity (97), interstitial fibrosis (44), benign pleural disease (22) and others (84). Concentrators were used by 253 patients and high-pressure compressed gas cylinders by 307. Arterial blood gas analyses were registered for 547 patients. The mean arterial oxygen tension (PaO2) when breathing air was 6.5 +/- 1.1 kPa and 9.0 +/- 1.4 kPa when breathing oxygen. The mean arterial carbon dioxide tension (PaCO2) without oxygen was 6.5 +/- 1.5 kPa and 6.8 +/- 1.5 kPa with oxygen. The register forms a data-base which can be used for the evaluation of different home oxygen systems, regional differences in the access to treatment and treatment performance and decisions relating to health care economics.

Adolescent↗
PubMed1986

Airflows after inhalation of terbutaline sulphate aerosol from a 750-ml spacer for four weeks.

Terbutaline sulphate was administered to 40 adult asthmatic patients via an ordinary metered-dose inhaler (MDI) or one connected to a 750-ml spacer in an open, randomized, crossover study. Spirometry was obtained before the start of the study and again after four weeks of treatment with each inhaler. The patients recorded on a diary card the severity of their asthma symptoms and the peak expiratory flow rate (PEFR) in the morning before and after drug administration and in the evening. Preinhalation spirometric values were higher after four weeks with the 750-ml spacer than at the start of the study (P less than or equal to 0.05). Daily morning and evening PEFR values were higher after use of the 750-ml spacer than after use of the ordinary MDI (P less than 0.05). Daily symptom scores were generally low. A significantly better effect (P less than or equal to 0.05) with the 750-ml spacer was achieved only in daytime dyspnea. The investigators conclude that the attachment of a 750-ml spacer to an ordinary metered-dose inhaler can improve the efficacy of terbutaline sulphate in the long-term treatment of asthma.

Adult↗