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Biomedical subjects

M Salo

Publications and source records attributed to M Salo.

At least 73 records · Page 4Linked to original sources

Serum fatty acids in Finnish men.

The fatty acid compositions of 4 serum lipid fractions were analysed from 244 randomly selected 30-59-year-old Finnish men from 4 areas involved in a population survey ('Mini-Finland') in 1979-80. Men in eastern Finland had significantly lower mean percentages of linoleate (18:2) in CE, TG, FFA and PL (45.1, 10.3, 9.3 and 18.8%, respectively) than men in the western part of the country (48.4, 12.5, 10.6 and 20.2%, respectively). Very low values of 18:2 were encountered in the North Karelian community of Ilomantsi, especially in men aged 50-59 (40.9, 8.0, 7.5 and 16.8%, respectively). The percentage of alpha-linolenate tended also to be lower and those of saturated and monounsaturated fatty acids higher in the east, but there were no or only inconsistent differences in the contents of the prostaglandin precursors dihomo-gamma-linolenate, arachidonate and eicosapentaenoate. Eighteen men were studied in November and the following April. Only minor changes in the mean composition of serum fatty acids took place during this period and the correlation coefficients between the percentages of 18:2 recorded at the two time points ranged from 0.70 to 0.81. The low concentrations of 18:2 in serum lipids in Finnish men obviously reflect a low dietary P/S ratio and may contribute to the high prevalence of IHD in Finland and to its regional differences.

Adult↗

Prolonged impairment of cell-mediated immunity after major abdominal surgery in malnourished patients.

The effect of the nutritional status on postoperative impairment of the immune response was studied in adults undergoing major abdominal surgery. The immune function was evaluated by measuring in vitro the lymphocytic response to phytohaemagglutinin (PHA), concanavalin A (Con A) and the purified protein derivative of tuberculin (PPD) in whole blood cultures, and in vivo delayed skin hypersensitivity to candida, mumps, streptokinase-streptodornase and PPD. Nutritional assessment was carried out by evaluating recent weight loss, the weight for height index and by measuring the arm muscle circumference (AMC), triceps skinfold thickness (TSF), the creatinine-height index (CHI) and the serum concentration of albumin and prealbumin. The patient was considered malnourished, if at least three of these criteria were abnormal. The immune parameters were measured preoperatively, at the end of the surgery and five days after operation. Before the operation both malnourished and well-nourished patients had normal lymphocytic responses, but the malnourished patients had a slower recovery of immune responses after the operation and they had an increased number of postoperative complications. No significant differences in the incidence of anergy were observed between the well and malnourished patients pre or postoperatively.

Journal Article↗

Pharmacokinetic studies on atropine with special reference to age.

Pharmacokinetic studies on atropine were performed in 52 patients under general or spinal anaesthesia. Age had a clinically significant effect on the kinetics of this alkaloid: in children under 2 years of age and in the elderly a prolonged elimination was found. This might explain, partly at least, the higher sensitivity of these age groups to the effects of atropine. Age had no effect on the serum protein binding of this alkaloid. Atropine was found in human CSF after a single i.m. administration, but not after a single i.v. administration. During anaesthesia after i.v. atropine administration, a diminished cardiovascular response was found in the elderly in comparison with healthy adult patients. This indicates changes also at the cholinergic receptor sites in the elderly.

Adolescent↗

The passage of flunitrazepam into cerebrospinal fluid in man.

The passage of flunitrazepam into cerebrospinal fluid (CSF) was studied in 23 surgical patients (group 1), after a single 0.02 mg/kg intravenous injection, in 9 otherwise healthy patients undergoing neurological examination (group 2), after a single 2 mg oral dose, and in 9 chronically-ill neurological patients (group 3), after 2 to 4 successive 2 mg oral doses. Flunitrazepam in plasma and the CSF was determined by gas chromatography and its plasma protein binding by equilibrium dialysis. Uptake of flunitrazepam into human CSF was found to very fast: even 5 min. after intravenous injection the drug level in the CSF was 2.8% of the corresponding plasma concentration. CSF levels increased up to 77 min. after intravenous injection. In group 2 the mean percentage level in the CSF was 23.5 +/- 13.0 (S.D.) and in group 3 it was 16.7 +/- 3.1. In group 1, 22.9+/- 8.0% of flunitrazepam was not bound to plasma protein, in group 2, 12.1 +/- 8.3% and, in group 3, 30.3 +/- 14.1%. Groups 1 and 2 (P less than 0.01) and 2 and 3 (P less than 0.01) differ significantly from each other. In groups 2 and 3 there was no significant correlation between the percentage not bound to protein and CSF levels of flunitrazepam. The uptake of flunitrazepam by CSF provides an explanation for its rapid drug effects. Its binding to plasma protein is affected by disease and, possible, by other drugs.

Adult↗

Suppressor lymphocytes during open heart surgery.

Open heart surgery is associated with a moderate to severe postoperative of cell-mediated immunity. To characterize this defect, T-suppressor lymphocytes were studied in nine patients undergoing elective aortic/mitral valve replacement surgery. A decrease of the number of T-suppressor lymphocytes was observed after the operation. At the same time the activity of concanavalin A (Con A)- and phytohaemagglutinin (PHA)-induced suppressor cells decrease. Thus the decrease of cell-mediated immunity after open heart surgery seems not to be due to activation of suppressor lymphocytes.

Adult↗

Plasma concentrations of lidocaine (lignocaine) after cranial subcutaneous injection during neurosurgical operations.

After cranial subcutaneous injection of lidocaine 0.8-3.7 mg/kg+adrenaline (epinephrine) 1:200,000 in neurosurgical patients, fast drug absorption was found with peak plasma concentrations of 0.6-1 microgram/ml in 5-10 min. However, the concentrations remained above the lowest effective antiarrhythmic level of 0.6 microgram/ml for only about 10 min. In one patient, simultaneously administered intravenous lidocaine had an additive effect on those levels. Induced hypotension (sodium nitroprusside) during aneurysm operations decreased the arterial plasma level of lidocaine and was followed by a new peak after discontinuation. Thus the absorption of a drug during induced hypotension from subcutaneous tissue is often erratic.

Adult↗

Effect of halothane anaesthesia on primary antibody response in the chicken.

The effect of a single anaesthesia of 2 hours' duration with 1% v/v halothane and of 1, 2, and 3 hours' duration with 2% v/v halothane was studied on the primary antibody response in line-bred chickens. In contradistinction to earlier studies, the immunisation was performed during anaesthesia to resemble antigenic exposure in surgical practice. The IgG and IgM antibodies against the antigens, bovine serum albumin (BSA) and formalin-killed Brucella abortus organisms (Brucella), were quantified by the enzyme-linked immunosorbent assay (ELISA). The halothane concentration of the blood was measured by gas chromatography at the end of anaesthesia. Anaesthesia with 1% and 2% v/v halothane given in the antigen-processing phase of humoral immune response had no effect on the concentrations of IgG-and IgM-anti-BSA and IgG-and IgM-anti-Brucella antibodies in the primary antibody response.

Anesthesia, Inhalation↗

Plasma lidocaine concentrations after different methods of releasing the tourniquet during intravenous regional anaesthesia.

Different methods of tourniquet release have been proposed to decrease the concentrations of local anaesthetic released into the systemic circulation at the end of intravenous regional anaesthesia. The effect of releasing the tourniquet intermittently with 5 seconds (group I) and 30 seconds (group II) deflation periods or at once (group III) was studied in 25 adult patients after intravenous regional anaesthesia with 40 ml of 0.5% lidocaine. The venous plasma lidocaine concentrations from the contralateral arm were measured by gas chromatography. There was no leakage of lidocaine from the occluded arm into the systemic circulation. The mean maximum plasma lidocaine concentration in group I 1.99 +/- 1.45 (SD) microgram/ml, in group II 1.33 +/- 0.54 microgram/ml and in group III 1.56 +/- 0.88 microgram/ml (P greater than 0.05) was below the toxic concentrations reported in the literature. There were subjective complaints such as dizziness and ringing in the ears in 4 out of the 7 patients in group I, in 2 out of the 9 patients in group II and in one of the 9 patients in group III (P greater than 0.05). There was no correlation between the duration of tourniquet time (range 12-87 minutes) and the maximum plasma lidocaine concentration. The intermittent release of the tourniquet did not decrease the venous plasma lidocaine concentrations in the contralateral arm; neither did comparing the lidocaine pharmacokinetics in 5 patients of group II after tourniquet release and in the 5 healthy volunteers after a single 100 mg intravenous lidocaine injection reveal any differences.

Adult↗

Impaired lymphocyte transformation after accidental trauma.

The effect of accidental trauma on lymphocyte transformation induced by phytohaemagglutinin (PHA), concanavalin A (Con A), pokeweed mitogen (PWM) and purified protein derivative of tuberculin (PPD) was studied in 66 patients with minor, moderate or multiple trauma. An in vitro whole blood micromethod was used. The lymphocyte transformation induced by the mitogens and the antigen was impaired in patients with trauma in proportion to the severity of the injury. A decrease of lymphocytic responses to a very low level had prognostic value for the patient as indicated by the two patients with very low lymphocytic responses and serious infectious complications.

Adult↗

Effect of halothane anaesthesia on secondary antibody response and mitogen-induced lymphocyte transformation in the chicken.

The effect of a single halothane anaesthesia on the secondary antibody response and the lymphocyte response in vitro to phytohaemagglutinin (PHA) and concanavalin A(Con A) was studied. The antigens used were bovine serum albumin (BSA) and killed Brucella abortus organisms (Brucella). IgG and IgM antibodies against these antigens were quantified by solid-phase radioimmunoassay. Lymphocyte transformation was studied by a whole blood micromethod. The chickens were anaesthetised for two hours with 2% v/v halothane. The halothane concentration of the blood was measured by gas chromatography at the end of the anaesthesia. Halothane anaesthesia had no effect on the secondary antibody response against BSA and Brucella. In contrast, it caused a significant decrease in the lymphocyte response to PHA and Con A. This suppression was transient, however, and full recovery of the lymphocyte function was observed by the first day after anaesthesia.

Animals↗

Effect of anaesthesia and surgery on the number of and mitogen-induced transformation of T- and B-lymphocytes.

Lymphocyte responses are affected by anaesthesia and surgery. 52 patients were studied to ascertain the affect on lymphocytic responses of thiopentone +N2O +O2, combined, diethyl ether +N2O +O2, and local anaesthesia in connection with surgery. The variables followed were: the leucocyte and differential count, the T- and B-lymphocyte count, and lymphocyte transformation by phytohaemagglutinin (PHA), concanavalin A (Con A), pokeweed mitogen (PWM), and purified protein derivative of tuberculin (PPD) in cultures using separated lymphocytes and whole blood. Thiopentone +N2O +O2 anaesthesia together with uterine curettage caused a decrease in the total lymphocyte and T-lymphocyte counts. The Con A response of separated lymphocytes decreased, but the response to other mitogens increased. Combined anaesthesia with thiopentone +N2O +O2 + analgesic + muscle relaxant together with surgery decreased the total lymphocyte and T-lymphocyte counts. The separated lymphocytic and whole blood cultures revealed throughout a decrease in the mitogen and PPD responses. Diethyl ether +N2O +O2 and local anaesthesia, both together with surgery, produced no statistically significant changes in the total lymphocyte or in the T- and B-lymphocyte counts. The mitogen and PPD responses in these groups showed throughout a fall in lymphocyte transformation. Neither patient's age, sex, nor the duration of the anaesthesia or operation affected the magnitude of the changes. The increase in the leucocyte count and in the percentage of neutrophils and the decrease in the percentage of eosinophils and lymphocytes and in the mitogen- and PPD-induced lymphocytic responses increased with the severity of the operative trauma. A new finding was the correlation observed between the changes in the leucocyte and differential counts and the decrease of lymphocytic responses in whole blood culture. The findings in this study indicate that operative trauma determine the decrease in lymphocytic responses associated with anaesthesia and surgery.

Adult↗

Immunosuppression after cholecystectomy.

The effect on immune functions of cholecystectomy under combined anaesthesia was studied in nine patients. The parameters examined were the leucocyte and differential count, the T-and B-lymphocyte count, and the lymphocyte transformation induced by phytohaemagglutinin, concanavalin A, pokeweed mitogen and purified protein derivative of tuberculoprotein. The anaesthesia and operation decreased the total lymphocyte count in the peripheral blood. No significant change occurred in the proportion or absolute number of E-binding (T) lymphocytes. The proportion of EAC-binding (B) lymphocytes increased, although no change was observed in the lymphocytes with surface immunoglobulin representing another B-cell marker. A statistically significant decrease was found in the lymphocyte response to all the mitogens used both in cultures with isolated lymphocytes and in whole blood. The changes returned to the pre-induction level on the third postoperative day. These finding suggest a transitory decrease of cell-mediated immunity after cholecystectomy.

Adult↗

Effect of atropine-pethidine premedication on peripheral blood lymphocytes.

Phenothiazines, which are also employed for premedication, are known to have an inhibitory effect on the cell-mediated immunity. Therefore, the effect was studied in nine patients of the most commonly used atropine-pethidine premedication on the leucocyte and differential count, the number of T-and B-lymphocytes and the lymphocyte transformation by phytohaemagglutinin (PHA), Concanavalin A (ConA), pokeweed mitogen (PWM) and purified protein derivative of tuberculin (PPD) in cultures of separated lymphocytes and of whole blood. The premedication increased the proportion and absolute number of surface immunoglobulin-positive (B) lymphocytes in the peripheral blood and reduced the PHA and PPD responses in whole blood cultures. These vague changes in the immune response after premedication are of no importance in clinical work.

Adult↗

Effect of calcium p-chlorphenoxyisobutyrate and calcium carbonate on plasma lipids and lipoproteins of patients with hyperlipoproteinaemia.

Since dietary calcium had been reported to reduce plasma lipids, the effects of calcium carbonate (CaCO3, 2 g/day) and the calcium salt of p-chlorphenozyisobutyrate (Ca-CPIB, 2 g/day), both singly and in combination, were studied in outpatients with primary hyperlipidaemia. Three groups of five patients were followed in a double-blind cross-over study, in which placebo and the drugs were given alternately during four-week periods. The main results were: 1) CaCO3 alone did not produce any significant changes in plasma lipids. 2) Ca-CPIB reduced LDL-cholesterol in patients with type IIa and IIb by an average of 29 and 21%, respectively. It also lowered VLDL-triglyceride by 50% in type IIb and by 48% in four out of five patients with type IV. 3) The combination of CaCO3 and Ca-CPIB reduced LDL-cholesterol by 31 and 25% in types IIa and IIb, respectively. It also lowered VLDL-triglyceride by 48-52% in types IIa and by 46% in four out of five patients with type IIb. 4) Three out of five patients with type IV had a rise of LDL-cholesterol while on Ca-CPIB alone; two of the patients had the rise while on the combination. 5) After treatment with Ca-CPIB, either singly or in combination, there was a statistically significant lowering of ESR and of plasma inorganic phosphate and alkaline phosphatase. No clinical side effects were noted.

Adult↗