Fibromyalgia and disability.
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Chronic Disease↗
Biomedical subjects
L Jacobsson
Publications and source records attributed to L Jacobsson.
The use of iohexol clearance to determine GFR in patients with severe chronic renal failure--a comparison between different clearance techniques.
UNLABELLED: The nonionic low-osmolar contrast medium iohexol was used as marker of glomerular filtration rate (GFR) in 53 patients with stable renal function (group I: n = 32, group II: n = 21). All the patients had clearance values < or = 30 ml.min-1.1.73 m-2 body surface; 40 patients < 20 ml.min-1.1.73 m-2 body surface. Simultaneous determinations of renal clearance and plasma clearance, both as slope clearance and single sample clearance, were performed after intravenous injection of 10 ml iohexol 300 mg iodine/ml. In groups I and II plasma was sampled early (around 3 hours) and late (up to 24 hours) after the injection. In group I urine was collected during four 40-minute periods and in group II during one 3-hour period and in group II the residual urine was estimated by ultrasound. Plasma and urine iodine concentrations were analyzed with X-ray fluorescence technique (Reanalyzer PRX90, Provalid AB, Sweden). In group II S-creatinine and tubular function test were followed to detect any signs of nephrotoxicity. In 6 anuric patients (group III) 10 ml iohexol 300 mg I/ml was injected to assess its extrarenal clearance. In groups I and II the slope clearance correlated excellently with the single sample clearance (r = 0.99) when a late plasma sample was used in both techniques. In group II, where residual urine was estimated by ultrasound, renal clearance correlated better with slope clearance than in group I (r = 0.94 vs r = 0.89). There were no signs of nephrotoxicity in the parameters noted. In group III, extrarenal plasma clearance of iohexol did not exceed 2 ml.min-1.1.73 m-2. CONCLUSION: GFR < 20 ml/min can accurately and safely be determined as renal clearance or plasma clearance of iohexol after an intravenous dose of 10 ml 300 mg I/ml. Plasma clearance techniques, which have the practical clinical advantage of no urine sampling, do at low GFR require a late plasma sample taken, for instance, 24 hours after injection of iohexol, irrespective of whether slope technique or single sample technique or one-compartment or poly-compartment models are used.
Adult↗
Regional cerebral blood flow in normal pressure hydrocephalus: diagnostic and prognostic aspects.
Relative regional cerebral blood flow (rrCBF) was measured by single-photon emission tomography (SPET), using technetium-99m-d,l-hexamethylpropylene amine oxime (HMPAO) as flow tracer, in 23 patients with normal pressure hydrocephalus (NPH). 1000 MBq 99mTc-HMPAO was given intravenously and the rrCBF calculated as regional/cerebellar count level ratios. The patients were examined before and 3-12 months after ventriculoperitoneal shunt surgery. rrCBF was also determined in ten healthy aged matched volunteers who served as controls. The NPH patients had decreased rrCBF in the hippocampal regions and in the frontal and parietal white matter as compared to the controls. The frontal/parietal rrCBF ratio correlated with both psychiatric disability and the preoperative degree of incontinence. Decreased flow in frontal white matter, frontoparietal and hippocampal grey matter and a low frontalparietal grey matter flow ratio preoperatively correlated with improvement in both Mini Mental State score and psychiatric disability after shunt surgery. After shunt surgery the rrCBF increased in the mesencephalon, frontal grey and white matter, parietal white matter and hippocampus. The flow increase in hippocampal regions and frontal white matter correlated with improvement in psychiatric symptomatology. The results of this study regarding the frontal and hippocampal rrCBF patterns, and the clinical correlation, support the hypothesis that CBF changes in these regions are of pathophysiological and prognostic importance in NPH.
Adult↗
125I-labelling of an internally 75Se-labelled monoclonal antibody--biodistribution in tumour-bearing nude mice.
A monoclonal antibody, C215, was first internally labelled with 75Se-methionine and then labelled with 125I. The biodistribution of the dual-labelled [125I][75Se]C215 was studied in tumour-bearing nude mice killed 3 days after injection. The biodistribution of the dual-labelled [125I][75Se]C215 was compared with the biodistribution of single-labelled [131I]C215 and [75Se]C215. Iodine-labelled antibodies seem to be damaged during iodination, affecting the disappearance rate and tumour uptake. There were no signs of dehalogenation of circulating antibodies or antibodies taken up in the tumour.
Adenocarcinoma↗
Determination of low glomerular filtration rate using iohexol clearance.
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Glomerular Filtration Rate↗
Determination of split renal function from gamma camera renography: a study of three methods.
Three different methods for calculation of the split kidney function from gamma camera renography with 99Tcm-DTPA are surveyed in this study, the integral, the slope and the uptake index methods. The reproducibility in calculating the relative renal function was very good with all three methods (coefficient of variation 2-4%). Single kidney glomerular filtration rate (GFR) was assessed by the three methods and 51Cr-EDTA clearance prior to nephrectomy, giving the accuracy of each method. The slope and uptake index methods showed high accuracy (0.9-2.0 ml min-1), while it is significantly reduced with the integral method (4.6 ml min-1), compared to the postoperative 51Cr-EDTA clearance. The uptake index method enables calculation of a ratio between the kidneys (alpha/UI)SR, which relates each kidney's intrarenal blood volume (alpha) to its renal function (UI). This ratio was compared in a group consisting of 38 patients with kidney tumours and in a control group of 32 patients. It was rather constant in the control group but significantly higher and within a wider range in the group with renal tumours. These discrepancies may indicate an abnormal intrarenal blood volume. Furthermore, the correlation between results assessed by the three calculation methods in the control group was good, while the correlation in the group with renal tumours deteriorated.
Adolescent↗
A new method for the relative quantification of rCBF examined by 99Tcm-HMPAO SPECT.
A new method for the analysis of regional cerebral blood flow (rCBF) studies, the 'Min-Max' method, was compared with the conventional method, the 'Average' method. Regional CBF was examined by single photon emission computed tomography (SPECT) using 99Tcm-hexamethylpropyleneamine oxime (99Tcm-HMPAO). The two methods were used to quantify the rCBF in a population of patients with various dementia disorders, and in healthy controls. Results from a phantom were also used. In the Average method the average counts per pixel (cp-1) within irregular manually drawn regions of interest (ROIs) was registered. In the Min-Max method the minimum cp-1 and maximum cp-1 within rectangular ROIs were registered for white and grey matter, respectively. The relative rCBF (rrCBF) was calculated as the ratio between the regional and cerebellar values. The Min-Max method gave systematically lower values for rrCBF in the white matter, in both clinical studies, and in the phantom, compared to the Average method. No difference was found in the grey matter results. The variability in rrCBF in the phantom study was greater with the Min-Max method than with the Average method, but this effect was counteracted in the clinical studies by a smaller interobserver error. The average regional differences between patients and controls appeared greater with the Min-Max method than with the Average method. The Min-Max method proved to be more simple to execute, involved a smaller observer error, and with respect to ability to distinguish patients with dementia disorders from controls, it appears to function at least as well as the accepted Average method.
Adult↗
Quantitative SPECT cisternography in normal pressure hydrocephalus.
Twenty-one patients with normal pressure hydrocephalus (NPH), 8 patients with various brain diseases with an element of hydrocephalus, and 7 patients with miscellaneous dementia disorders were investigated with quantitative radionuclide cisternography (RC) using single photon emission computerized tomography (SPECT). The total intracranial counts as well as the counts in the lateral and third ventricles were measured. All 15 NPH patients accessible for postoperative examination were improved after shunt surgery. In all groups the ventricular and total intracranial counts level increased during the measurement period but remained constant in distribution in each group. The NPH patients had a higher relative count value in the lateral and third ventricles compared to the patients with miscellaneous dementia disorders. The relative values in the third and lateral ventricles were predictive for the outcome of shunt surgery. Quantitative SPECT RC appears to be a useful diagnostic procedure in NPH investigations.
Adult↗
Parasuicide in the Nordic countries.
This article gives an account of some findings of the WHO/EURO multicentre study on parasuicide from the five Nordic centres: Helsinki (Finland), Stockholm (Sweden), and the countries of Funen (Denmark), Sø-Trøndelag (Norway) and Västerbotten (Sweden). For parasuicide patients treated in hospital in these five Nordic centres, the parasuicide rates per 100,000 inhabitants per annum were 222 for women, 213 for men and 224 for both sexes combined. In all the Nordic centres except Helsinki, women had higher parasuicide rates than men. The female/male parasuicide ratio was 1.16 for all Nordic centres. The highest parasuicide rates in the whole material were found in Helsinki, Stockholm and Funen, and the lowest in Sør-Trøndelag and Västerbotten. The highest parasuicide rates lay in the 30-39 age interval, i.e. the peak of parasuicide rates was in older age groups than previously reported. Single people, especially divorcees and those who have never been married, constitute a high-risk group in both sexes. The risk of parasuicide for single men is three times that for married men in all the Nordic centres except Sør-Trøndelag, where the risk is five times higher. The parasuicide risk for single women is twice as high as for married women except for women in Funen, where the risk for single and married women is almost equal. Exceptionally high parasuicide rates are also reported for Finnish citizens in Sweden, compared with Finns from the Helsinki centre. Parasuicide rates appear to be correlated with population density, since the densely populated areas of Helsinki, Stockholm and Funen evince higher parasuicide rates than the sparsely populated areas of Sør-Trøndelag and Västerbotten.
Adolescent↗
Total exchangeable sodium related to body composition in patients with conventional or reservoir ileostomy.
Decreased exchangeable body sodium might be a consequence of proctocolectomy and construction of an ileal reservoir. To investigate this, 35 patients with ulcerative colitis and conventional ileostomy were studied before and after conversion to continent ileostomy and compared with 25 unoperated subjects as reference. The sodium urinary excretion varied between 7 and 229 and 1 and 217 mmol/24 h in patients with conventional and reservoir ileostomy, respectively. The total exchangeable sodium was measured and related to body composition estimated from body weight, total body water, and total body potassium. No effect on exchangeable sodium was observed after conversion: 3100 mmol and 2990 mmol, respectively. Patients with ileostomy, regardless of type, did not differ from reference subjects in their exchangeable sodium when related to total body water. A larger variation of total exchangeable sodium related to total body water suggests unstable sodium homeostasis in patients with ileal reservoir compared with reference subjects.
Adult↗
Salivary gland scintigraphy in subjects with and without symptoms of dry mouth and/or eyes, and in patients with primary Sjögren's syndrome.
The major salivary glands were examined with 99m-Tc-pertechnetate scintigraphy in randomly selected subjects with (n = 30) and without (n = 12) symptoms of dry mouth and/or eyes, and in patients with primary Sjögren's syndrome (1 degree SS, n = 17). The scans were quantitatively evaluated and compared to other objective tests used to diagnose 1 degree SS. As compared with those for asymptomatic subjects, most values for the scintigraphic variables were non-significantly lower for symptomatic subjects and the time-activity curves were slightly flatter for all major salivary glands. In patients with 1 degree SS most values for the scintigraphic variables were significantly lowered and the submandibular glands were the glands most affected, as reflected in a flat time-activity curve, while the parotid glands were mainly affected during stimulated secretion. The scintigraphic variables correlated with the self-rated dryness of mouth in symptomatic subjects and with the abnormality of sialometry results in patients with 1 degree SS. We conclude that salivary gland scintigraphy is a sensitive and valid method to measure salivary gland function and abnormalities.
Aged↗
Gamma camera renography with 99Tcm-DTPA: the impact of variations in input plasma curve on estimated GFR.
In an attempt to improve the reliability in estimating glomerular filtration rate (GFR) from gamma camera renography without blood sampling, we have investigated the impact of plasma input region of interest (ROI) size and location and the effect of the time delay between the circulation peak in the renal curves and in the plasma curve. An uptake index (UI) was calculated using plasma ROIs of five different sizes (8-56 cm2) and compared with measured 51Cr-EDTA clearance. The spread of the estimated GFR was not affected by the variations in plasma ROI size but different relations were obtained between UI and GFR. The plasma ROI markedly affected the estimated GFR (a deviation of 3.5 cm from the maximal region led to an overestimation of the GFR of 36%). Furthermore, the most reliable GFR estimate (S.D. 10.5 ml min-1) was achieved by including the whole circulation peak in the calculation time interval of the time delay-adjusted renogram, except the first frame. The time delay adjustment also enabled the calculation of a factor alpha, which represents the ratio between the blood volume within the renal ROI and that within the plasma input ROI. An abnormal alpha/UI ratio would suggest an unreliable GFR estimation.
Adult↗
[Central American seminars for young psychiatrists of the region and training of leaders in community mental health. Sweden/PAHO-WHO collaboration program].
The Swedish Psychiatric Association, in collaboration with the Department of Psychiatry, University of Umeå, Sweden, and the Pan American Health Organization/WHO, has obtained economic support from the Swedish Agency for International Development (ASDI), to organize training seminars for young psychiatrists from Central America. The program will continue until 1995 with an option to pursue further studies leading to a master or other post-graduate degrees. The overall purpose is to strengthen the knowledge in epidemiology and community mental health, along the lines set by the "Caracas Declaration" of a cadre of young leaders in the field of psychiatry in Central America.
Adult↗
Angiotensin converting enzyme inhibitors and atherosclerosis.
This study was designed to evaluate possible antiatherosclerotic effects of angiotensin converting enzyme inhibitors in mini-pigs. Experimental hypercholesterolemia and atherosclerosis were produced in mini-pigs of the Göttingen strain by adding 11% egg yolk and 1% cholesterol to the diet for 52 weeks. The animals were divided into three groups. One group was fed the atherogenic diet alone and served as control. The second group was treated with captopril in a dose of 80 mg/kg/day added to the atherogenic diet on an individual basis. The third group was treated with fosinopril in a dose of 8 mg/kg/day. Both drugs produced a significant reduction in serum ACE activity associated with a reactive rise in plasma renin activity and a slight fall in serum aldosterone concentration. The drug treatment had only minor effects on plasma lipids. The aorta and the carotid and coronary arteries were examined for atherosclerotic lesions. Atherosclerotic plaques developed in the abdominal aorta whereas fatty streaks were present in the thoracic aorta and the coronary arteries. Both drugs significantly reduced the percent visible atherosclerosis in the abdominal aorta. Furthermore, the accumulation of cholesterol in the thoracic and abdominal aorta was significantly reduced. The effect of captopril and fosinopril on endothelium-dependent relaxation of iliac arteries was examined. After addition of 3 x 10(-7) M acetylcholine strips from basal diet fed mini pigs showed a remaining tension of 7.0% +/- 7.1 (p < 0.05 compared to cholesterol-high diet), cholesterol-high diet 36.4% +/- 10.2, captopril 16.9% +/- 4.9 (p < 0.01) and fosinopril 31.7% +/- 4.6 (n.s.). It is concluded that the ACE inhibitors captopril and fosinopril inhibited the development of atherosclerosis in hypercholesterolemic mini-pigs.
Acetylcholine↗
[New psychiatric law in Russia. In certain aspects more far-reaching than the Swedish one].
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Commitment of Persons with Psychiatric Disorders↗
Therapy with 125I-labelled internalized and non-internalized monoclonal antibodies in nude mice with human colon carcinoma xenografts.
The therapeutic effects of 125I-labelled (18-97 MBq) monoclonal antibodies (MAb) C-242, C-215 and S-S.1 were studied in nude mice with human colorectal adenocarcinoma tumours. The antibodies were administered 2 or 10-16 days after implantation of the tumour cells. The monoclonal antibody C-242 was internalized into the tumour cells, C-215 was internalized to a lower degree while S-S.1 (unspecific MAb) was not internalized at all. No enhanced therapeutic effect of 125I-C-242 was observed, as a result of Auger electrons, compared with 125I-C-215 and 125I-S-S.1.
Adenocarcinoma↗
Regional cerebral blood flow in multiple sclerosis measured by single photon emission tomography with technetium-99m hexamethylpropyleneamine oxime.
The regional cerebral blood flow (rCBF) in 19 patients with multiple sclerosis (MS), 10 with a relapsing remitting course and 9 with a progressive course, was examined by single photon emission computed tomography (SPECT) using technetium-99m hexamethylpropyleneamine oxime ([99mTc]-d,l-HM-PAO) as flow tracer. Nine age-matched volunteers served as controls. Low rCBF in the frontal grey matter correlated with neurological disability (p < 0.01), low frontal grey and white matter perfusion correlated with impaired cognitive functions (p < 0.02), and low rCBF in the occipital regions correlated with impaired visual functions (p < 0.03) in the MS population. A relationship was also found between reduced parietal white matter perfusion and the duration of the disease (p < 0.005). Patients with progressive MS had significantly reduced rCBF in the frontal grey matter compared with relapsing remitting MS patients and controls (p < 0.05). No other rCBF differences were found. As a diagnostic tool in MS, SPECT-[99mTc]-d,l-HM-PAO was found to be insensitive.
Adult↗
Ambivalence towards parenthood among pregnant women and their men.
369 pregnant women and 345 expectant fathers visiting antenatal clinics were examined by a questionnaire concerning attitudes towards pregnancy and parenthood. Data were processed by factor analysis and the degree of agreement to important factors was estimated. Attitudes were dominated by two conflicting views: children mean existential satisfaction and children mean restriction of freedom for women as well as for men. There was a tendency to deny the items concerning the disadvantages of having children. An important factor in the women's as well as in the men's analysis was the importance of own parents as models in parenthood. The findings from this unselected population of pregnant women and their men are consistent with earlier in-depth interviews. It can be concluded that ambivalence should be regarded as a normal constituent of the adaptation to pregnancy and parenthood. Experiences of own parents play an important role in the transition to parenthood. An important task for the medical profession should be to inform about ambivalence as a normal phenomenon as it, left unaccepted, may cause unnecessary anxiety and feelings of guilt.
Attitude↗