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Biomedical subjects

L Wibell

Publications and source records attributed to L Wibell.

At least 91 records · Page 5Linked to original sources
PubMed1978

Evaluation of urinary myoglobin assay test for myocardial infarction.

Serial determinations of urinary myoglobulin, beta2-microglobulin and albumin, and of serum myoglobin, were performed in twenty-eight consecutive patients admitted to a coronary care unit. Patients with myocardial infarction (MI patients) all had higher serum levels of myoglobin then those with other diagnoses (OBS patients). Myoglobinuria occurred in 80% of MI patients and in half of the OBS patients. The appearance of myoglobin in urine was mainly accounted for by an impaired renal reabsorption of low molecular weight proteins. Measurement of urinary myoglobulin, in contrast to serum myoglobulin, is of little value for the diagnosis of myocardial infarction.

Aged↗
PubMed1978

Urinary excretion of cyclic AMP in hyperparathyroidism.

The urinary excretion of adenosine 3', 5'-monophosphate (cAMP) was investigated in 15 subjects with primary hyperparathyroidism prior to parathyroidectomy and in 13 of them also after the operation. In comparison with healthy control subjects the cAMP excretion was raised in 8 of the patients pre-operatively and after operation all values had become normal. The discriminatory value of the cAMP analyses seemed to be increased by relating the cAMP values to the urinary excretion of calcium. With the applied methods determination of urinary cAMP was superior to a radioimmunoassay of parathyroid hormone in recognizing patients with primary hyperparathyroidism. In normal subjects it appeared that the cAMP excretion expressed per gram creatinine was somewhat higher in women than in men.

Adult↗
PubMed1978

The serum level and urinary excretion of beta2-microglobulin in health and renal disease.

In healthy subjects with normal renal function beta2-microglobulin (beta2m) is constantly produced in the body. It is eliminated almost exclusively by the kidneys, predominantly by glomerular filtration but possibly also by some direct uptake from the blood. After glomerular filtration more than 99,9% of excreted protein is reabsorbed in the kidney tubules where it is catabolized. The main factor, influencing on the serum level of beta2m is the GFR. Determination of S-beta2m appears to be more effective than analysis of S-creatinine for the detection of a slightly reduced GFR. A relatively high S-beta2m, in comparison with the GFR, may be seen in e.g. malignant proliferative disorders and SLE. This indicates an increased production of the protein. An entirely free passage over the glomerular membranes is not likely for beta2m in healthy subjects but the sieving coefficient might approach 1,0 in renal disease. The increased glomerular elimination of the protein could then possibly be counterbalanced by an increased synthesis, which should explain the pronounced relationship at a log/log scale between S-beta2m and the GFR. An increased excretion of beta2m in the urine is a sensitive indicator of proximal tubular dysfunction in many clinical conditions. In marked renal insufficiency there is, however, an obligatory 100-1 000-fold increase of the normal excretion, not related to the kind of renal disorder. In studies of the protein precautions are necessary to avoid degradation of the protein, in urine with a low pH.

Beta-Globulins↗
PubMed1977

Explorative parathyroidectomy before and after kidney transplantation.

Twentytwo parathyroidectomies were performed in a series of about 200 patients. Surgical exploration was performed in less than 5% of patients with slowly progressive uremia, and of patients on maintenance haemodialysis, whereas as many as 15% of patients returning to dialysis after graft failure were operated on. After successful transplantation appoximately 10% of a patients with an initially functioning graft ultimately had a neck exploration. On three occasions this parathyroidectomy was acutely performed. In about one third of the surgically explored cases the parathyroid glands displayed marked assymetry and/or histological features possibly indicative of adenoma formation or "autonomous nodules". The incidence of surgical complications was low and beneficial clinical effect were often encountered. It thus seems possible to defend a liberal attitude towards the performance of parathyroidectomy in patients accepted into a transplantation programme.

Adult↗
PubMed1977

Arterial disease with ischemic ulcerations in renal transplanted recipients.

Four cases of wide-spread arterial calcifications and peripheral necroses developing after successful renal transplantation are presented. In two cases parathyroidectomy was performed to prevent progress of the peripheral ischemic ulcers. In one of these cases, this was followed by healing of the necroses. In the two other cases parathyroidectomy had been performed because of hypercalcemia in the post-transplantation period. Ischemic ulcers appeared in these patients during treatment with vitamin D and healed after withdrawal of this therapy. Prevention of uremic arterial disease might be obtained by early control of serum phosphate levels and by renal transplantation at an early stage of renal disease. Parathyroidectomy should be considered in the treatment of developing peripheral gangrene in uremic patients and renal transplant recipients. Also, there are obvious hazards connected with vitamin D therapy in these patients.

Adult↗
PubMed1977

Calcium, phosphate and albumin in serum. A population study with special reference to renal stone formers and the prevalence of hyperparathyroidism in middle-aged men.

Serum valuse for calcium, phosphate and albumin have been determined in a population study of 2322 49-50-year-old men participating in a health examination survey. Calcium and albumin were significantly correlated (r = 0.34) but adjustment for albumin only caused minor effects on the distribution of calcium. No inverse relationship was found between calcium and phosphate. Seasonal variations over the three years of the health survey could not be established for either calcium or phosphate, whereas there was a slight tendency for albumin to decline during summer. The prevalence of hyperparathyroidism (HPT) in this population of men up to the age of 50 was 0.3% and among those with recurrent renal stones 5.3%. All subjects with verified HPT had a history of recurrent renal stones. One man on thiazide treatment had a slight elevation of calcium which returned to normal after cessation of the drug. No other case of hypercalcemia besides those caused by HPT was found. Mean values and frequency distributions for calcium, phosphate and albumin were almost identical in renal stone formers and matched controls. Hence it seems likely that other factors than those which markedly affect serum levels of calcium and phosphate are of major importance in common renal stone formation.

Age Factors↗
PubMed1976

Urinary excretion of beta2 microglobulin after the induction of a diuresis. A study in healthy subjects.

An increased diuresis was induced in each of four healthy subjects by intravenous infusion of urea, saline and sodium bicarbonate and by an oral water load. The excretion of a low molecular weight protein (LMW-protein), beta2-Microglobulin (beta2mu), was determined by a radioimmunoassay, the urinary concentrations of the protein being in the range 0.007-0,3 mug/ml. The hourly excretion of beta2 mu was not significantly influenced by varying loads of water, sodium, and osmoles which suggests that the tub ular reabsorption of LMW-proteins is stable under these conditions and that even a moderately increased excretion of such proteins may reflect a distrubed proximal tubular function.

Beta-Globulins↗
PubMed1976

Treatment with methenamine hippurate in the patient with a catheter.

Methenamine hippurate, 1 g twice daily, was given for four months to twenty-two elderly female subjects with an indwelling catheter. The incidence of catheter blockage was significantly reduced when compared with the control period of similar duration, although bacteriuria persisted throughout treatment. The incidence of symptomatic urinary tract infection also decreased during treatment with methenamine hippurate.

Aged↗
PubMed1976

The antianabolic effect of tetracyclines in a consecutive clinical series.

In a series of 58 tetracycline-treated patients from an intensive care unit 33 patients were given oxytetracycline and 25 patients were given doxycycline. In 50 of the patients the serum creatinine level never exceeded 2 mg/100 ml. The serum urea/creatinine ratio was repeatedly determined in all patients. The oxytetracycline group displayed significantly higher mean values for this ratio during treatment than the doxycycline group. This was interpreted as a probable antianabolic effect due to the oxytetracycline therapy.

Creatinine↗
PubMed1975

Arterial calcification and progressive peripheral gangrene after renal transplantation. Report of two cases treated with parathyroidectomy.

Two cases of progressive arterial calcification and peripheral gangrene after successful renal transplantation are presented. Parathyroidectomy was performed and was followed in one case by healing of the peripheral necroses. It is suggested that parathyroidectomy should be considered in similar cases even in the absence of hypercalcemia.

Arteriosclerosis↗