[3-day care of lower urinary tract infection in women].
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Anti-Infective Agents, Urinary↗
Biomedical subjects
M Ericsson
Publications and source records attributed to M Ericsson.
Pancreatic polypeptide-producing tumors. Report on two cases.
Histochemical, chemical and clinical features of two malignant endocrine pancreatic tumors were studied. Both tumors contained pancreatic polypeptide (PP)-immunoreactivity in the majority of tumor cells. In addition, one tumor contained a few scattered serotonin-fluorescent cells and the other scattered gastrin-immunoreactive cells. Pancreatic polypeptide hypersecretion was established from both tumors. Serotonin was produced by one tumor and gastrin was secreted by the other. No PP-associated endocrine symptoms were present, whereas the hypergastrinemia may have caused a bleeding duodenal ulcer in one patient. Although both tumors were highly malignant the clinical courses in the two patients were very different; one patient died within a few months whereas the other is alive 2 years after the diagnosis.
Adult↗
Decreased removal of triglycerides from the blood--a mechanism for the hypertriglyceridemia in male patients with coronary artery disease.
We determined serum apolipoprotein A I and A II concentrations and triglyceride and cholesterol concentrations in serum lipoprotein density classes in 28 male patients with severe ischaemic heart disease (IHD) and with angiographically verified coronary artery disease (CAD) and in age-matched controls. Both triglyceride and cholesterol concentrations in very low density lipoproteins and in low density lipoproteins were higher in IHD-patients than in the controls. The triglyceride but not the cholesterol concentration in serum was higher in IHD-patients than in the controls. The cholesterol in high density lipoproteins and the serum apolipoprotein A I concentration were lower in IHD-patients than in the controls. At least in part the higher triglyceride concentration in very low density lipoproteins could be attributed to a decreased removal of triglycerides from the blood since the fractional removal rate of an i.v. injected artificial triglyceride emulsion (Intralipid) was slower in IHD-patients than in the controls.
Adult↗
Peroperative studies of S-calcitonin in thyroid and peripheral venous samples from patients with normal C-cells, C-cell hyperplasia, and medullary carcinoma on the thyroid.
The calcitonin (Ct) secretion was studied during surgery in 11 patients with benign thyroid and/or parathyroid disorders and in six patients with familial medullary carcinoma of the thyroid (MCT) and C-cell hyperplasia (CCH). The preoperative diagnosis of MCT and CCH was established by S-Ct determinations before and after pentagastrin provocation. During surgery blood samples were collected from thyroid and peripheral veins before and after injection of 0.6 micrograms pentagastrin . kg-1 in the inferior thyroid artery. In the control group the thyroid venous concentration of S-Ct increased from 395 +/- 42 pmol . l-1 to 2,692 +/- pmol . l-1 after intra-arterial (i.a) pentagastrin. The basal value for S-Ct in thyroid venous samples from patients with MCT and CCH was distinctly elevated in five of six patients. After pentagastrin stimulation a very prompt and striking S-Ct peak in thyroid venous samples was demonstrated (range 11,500-2,700,000 pmol . l-1), which in all cases widely exceeded that in the control group. Varying responses were registered in peripheral vein samples. S-Ct values obtained in the present investigation constitute valuable information for the interpretation of S-Ct values obtained in thyroid venous catheterization studies.
Adult↗
Automatic analysis of the EMG interference pattern.
A method is described for the automatic analysis of EMG interference patterns obtained at optional non-controlled force levels. It is a modification of Willison's method of measuring turns and amplitude of the signal. In the method, the mean amplitude is plotted against turns obtained during 300 msec for each of 20 recording sites. Different voluntary strengths are used and a scatter of points is obtained. Confidence limits enclosing these points are constructed for healthy subjects for 4 different muscles with concentric and monopolar electrodes. The normal values differ with age, muscle, sex and electrode. The method is tested on patients with myopathic or neurogenic EMG and a high diagnostic yield is obtained. The method is objective, reproducible, fast and needs relatively small computer facilities.
Adolescent↗
Circulation, respiration and serotonin levels in carcinoid patients during neurolept anaesthesia.
Release of hormones peri-operatively in patients with metastatic carcinoids may lead to severe circulatory and respiratory disturbances. Fourteen patients with liver metastases were studied during 16 operations with a modified neurolept anaesthesia in order to evaluate the central haemodynamic and respiratory functions as well as plasma serotonin levels. The premedication in five patients was supplemented with levopromazine. During the 11 operations performed on patients not pretreated with levopromazine, no major significant fluctuations in circulatory or respiratory functions were recorded although big variations in serotonin plasma levels were measured. In the patients treated with levopromazine, however, significant changes were observed in heart rate, mean pulmonary artery pressure, cardiac index, and left and right ventricular stroke work especially during flushing episodes. However, these changes did not correlate with the changes in plasma serotonin levels. Modified neurolept anaesthesia without levopromazine pretreatment combined with careful monitoring seems to be a safe procedure for carcinoid patients. Using this type of anaesthetic procedure only one major complication occurred in connexion with 16 major operations and then in the postoperative period.
Adult↗
Failure of exogenous secretin to induce secretion of calcitonin in man.
The effect of secretin on calcitonin secretion from the human thyroid gland was studied in 15 patients undergoing thyroid and parathyroid surgery. Secretin was administered into the inferior thyroid artery at two different doses (0.75 and 7.5 CU) and into a peripheral vein at a dose of 75 CU. Blood samples for measurements of calcitonin and calcium were collected from thyroid or peripheral veins. However, neither intraarterially nor iv administered secretin was able to evoke any significant calcitonin response as measured in thyroid or peripheral venous blood. The calcium level was unaffected by secretin. The results demonstrate that secretin does not act as a calcitonin secretagogue in man.
Adult↗
Acute acalculous cholecystitis following trauma.
A consecutive series of 11 patients with post-traumatic acute acalculous cholecystitis is reviewed. Three patients had sustained multiple trauma, whereas 6 patients had recently undergone alimentary tract surgery and 2 patients orthopaedic or gynaecological surgery. All patients were treated by cholecystectomy. Four cases required reoperation because of an abdominal abscess and 2 cases because of a subcutaneous abscess. One patient was re-explored due to haemorrhage from the gallbladder bed, and another patient due to occlusion of the coeliac axis. The mortality rate was 18 per cent. The importance of early diagnosis and surgical intervention with cholecystectomy are emphasized in this rare condition with high morbidity and mortality.
Acute Disease↗
Temporary liver dearterialization in patients with metastatic carcinoid disease.
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Adult↗
Myocardial blood flow, oxygen uptake and carbon dioxide release of the human heart during hemodilution.
Myocardial blood flow, oxygen consumption and carbon dioxide release were studied before and during hemodilution in man. Dextran 70 was used as the dilutional agent to reduce hematocrit values from 37 to 28% (mean). The decrease of oxygen content in arterial blood after hemodilution was compensated by an increase of cardiac output. The myocardial blood flow increased proportionally more than the cardiac output, resulting in a virtually unchanged oxygen tension in coronary sinus blood. The metabolism of the heart was not affected as the respiratory quotient remained unchanged. This investigation suggests that blood losses up to 20% of the total blood volume can be replaced by dextran solutions, without a significant decrease of myocardial oxygen supply.
Adult↗
Computherm. A new device for measurement of coronary blood flow using the continuous thermodilution technique.
A new device for an automatic determination of coronary sinus blood flow using the thermodilution technique is presented. The measuring equipment consists of four main parts; a thermal dilution-catheter with two signal amplifiers of analogue type, an analogue/digital converter controlled by a microcomputer system, a pump for the control of the rate of injection flow and a control panel and display. The device has been tested in a model test with flow levels between 75 and 200 ml/min. The error between a number of measurements with all parameters unchanged except minor variations in temperatures was less than 5 per cent.
Computers↗
Evaluation of a dynamometer for measurement of isometric and isokinetic torques.
A modified version of the original Cybex II dynamometer with a temperature compensated strain gauge transducer has been evaluated. It was found that the calibration constant was dependent of the vertical load of the device. The ratio (k) between the applied and the recorded torque is angle independent during extension and k is equal to 1.18 and during flexion k is angle dependent and can be expressed as k = -.0008 theta + 1.208, where theta is the angle of flexion.
Biomechanical Phenomena↗
Serum lipoproteins and apolipoproteins A I and A II in male patients with peripheral arterial insufficiency.
Serum apolipoprotein A I and A II concentrations and triglyceride and cholesterol concentrations in serum lipoprotein density classes were determined in male patients with peripheral arterial insufficiency (PAI) and in controls. Both triglyceride and cholesterol concentrations in serum, very low and low density lipoproteins were higher in PAI patients than in controls. The cholesterol in high-density lipoproteins and the serum apolipoprotein A I concentration were lower in PAI patients than in controls. No difference between the groups was found for serum apolipoprotein A II concentration. The results show that the lipoprotein pattern in PAI is changed in roughly the same way as in ischemic heart disease.
Adult↗
Gelfoam powder embolization of the hepatic artery in liver metastases of carcinoid tumors.
Five patients with liver metastases of carcinoid tumors were treated with transcatheter embolization of the liver arteries with gelfoam powder. In three of four patients with flushing symptoms, these symptoms disappeared immediately after the treatment. One patient remained free of symptoms for 6 months. Another patient was free of symptoms at 1-month control but 1 year later he again had slight symptoms. The third patient had slight recurring symptoms at 1-month control. Liver angiograms performed on four patients 1 month after the embolization showed recanalized arteries and reduced vascularity of the tumors.
Aged↗
Serum lipoproteins, apolipoproteins and intravenous fat tolerance in young athletes.
Serum lipoproteins, apolipoproteins and intravenous fat tolerance were studied in 22 male athletes and compared with healthy age and weight-height matched controls. All of the subjects were non-smokers. Athletes had lower serum, very low density lipoprotein (VLDL) and low density lipoprotein (LDL) triglycerides, lower serum VLDL and LDL cholesterol and an increase in apolipoprotein A I. High density lipoprotein (HDL) cholesterol was similar in both groups. The clearance of i.v. injected triglyceride emulsion was faster in athletes. This suggests that the lower serum and VLDL triglycerides in athletes are at least in part due to a more rapid triglyceride clearance.
Adult↗
Surgical treatment of metastatic disease in the thyroid gland.
Metastatic disease in the thyroid gland is uncommon in clinical practice. Preoperative investigation with thyroid scan and fine-needle aspiration biopsy verified or strongly suggested metastatic disease in seven out of nine patients. All patients were treated by thyroid surgery. Three patients died within 4 months in disseminated disease. The remaining seven patients had a survival rate of between 1 and 5 years. Three patients are still alive 12, 29, and 48 months after thyroid surgery. Surgical treatment for metastatic disease in the thyroid, especially due to metastatic renal carcinoma and melanoma, is recommended.
Adenocarcinoma↗
Cimetidine inhibits the pentagastrin-induced release of calcitonin in normocalcaemic man.
Pentagastrin stimulates the release of calcitonin from normal C-cells in the human thyroid. In the present investigation the effect of cimetidine on the liberation of calcitonin in response to intraarterial pentagastrin (0.6 micrograms . kg-1) was studied in 14 normocalcaemic patients undergoing surgery for thyroid adenomas. Cimetidine was administered as a bolus injection of 200 mg followed by an intravenous infusion of 1.5 mg . kg-1 . h-1. In seven patients not given cimetidine, mean calcitonin concentration in the thyroid vein rose from 419 +/- 58 to 2787 +/- 645 pM in response to pentagastrin. In seven patients given cimetidine, mean calcitonin concentration only increased from 107 +/- 33 to 166 +/- 51 pM after pentagastrin. The difference between the two groups was statistically significant both during basal conditions (P less than 0.001) and in response to pentagastrin (P less than 0.01). The results suggest that pentagastrin affects normal C-cells via release of histamine and that cimetidine markedly interferes with this mechanism.
Adult↗
Basal and pentagastrin-stimulated levels of calcitonin in thyroid and peripheral veins during normocalcemia and chronic hypercalcemia in humans.
The calcitonin secretion from the thyroid C-cells was studied with a peroperative method. The calcitonin concentrations in thyroid venous effluent and peripheral veins were determined in patients who underwent operations because of thyroid and parathyroid disease. In normocalcemia the thyroid vein level of calcitonin was significantly higher than that in peripheral vein. In chronic hypercalcemia no gradient over the thyroid was demonstrable. After injection of pentagastrin into a thyroid artery a very pronounced, but transient, increase in calcitonin concentration was registered. No difference in peak value between normo- and hypercalcemia was demonstrable. The peripheral vein level was unchanged. The peroperative method is very sensitive. A marked peak in thyroid vein corresponds to unchanged values in peripheral vein. The method invites further studies with other secretagogues and receptor-blocking substances.
Adolescent↗