Biomedical subjects
Publications and source records attributed to R Andersson.
Reports on postsplenectomy septicemia have led to a more conservative attitude to treatment of splenic trauma. A case of traumatic rupture of the spleen treated with splenic artery ligation is presented. In the 5-year follow-up the investigations included repeated scintigraphy. Alternative management of traumatized spleen is discussed.
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Glomerular filtration rate (GFR) as measured by 51Chrome-EDTA clearance, decreased with a mean of 10 ml/min during therapy with ceftazidime 2 g bid in 16 patients with initial GFR of 30 to 110 ml/min. A significant increase in the excretion of urinary alanine aminopeptidase was also found. In another three patients with initial GFR of 17-22 ml/min increases in serum creatinine during therapy were noted. These observations indicate that ceftazidime should be used with caution in patients with impaired renal function and not be combined with nephrotoxic drugs until the safety of such combinations has been studied.
Cerebrospinal fluid (CSF) and serum samples from 361 consecutive patients were investigated. The protein pattern of each sample was examined by isoelectric focusing (IEF) of unconcentrated CSF followed by silver staining and by agar gel electrophoresis of concentrated CSF stained with amido black. 347 paired samples were compared. The results were the same in 83% of the samples. Discordant results were found in 10% of the samples. and in 7% additional information was achieved by one of the methods. IEF was superior to agar gel electrophoresis for the identification of oligoclonal immune reactions of the central nervous system. Tau globulin increase was seen in a few CSF samples, more often with IEF and then associated with other changes of the pattern. IEF of unconcentrated CSF followed by silver staining only requires 20 microliters CSF, while 3-4 ml CSF is needed for the agar gel electrophoretic method. It was concluded that IEF has several advantages compared to agar gel electrophoresis and is suitable as a routine method in clinical laboratories.
The records of 60 patients with acute intestinal ischemia treated between 1969 and 1982 were studied retrospectively. Fifty-three patients (88%) had thrombosis or embolus of the superior mesenteric artery and 7 patients (12%) occlusion of the superior mesenteric vein. Initial symptoms were obscure, although 25% presented with signs of peritonitis. The most frequently used investigation was plain abdominal X-ray with a positive finding in only 1/3. Forty-three patients (72%) were operated on. In 18 patients irreversible changes were found. Total mortality rate was 82%, in SMA-thromboembolism 85% and in SMV-thrombosis 57%. To improve the prognosis clinical awareness of the problem and attempts towards early diagnosis should be raised.
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The urinary excretion of hippuric acid and o-cresol was studied after respiratory exposure of human volunteers to approximately 80 ppm (306 mg/m3 +/- SD 13) of toluene for 2 h under different work loads (0, 50, 100, 150 W, respectively, during 30-min periods). The diet before and after exposure varied. An isotachophoresis method for the determination of hippuric acid is described. The correlation between the total urinary excretion, excretion rate and concentration of hippuric acid, and the respiratory uptake of toluene was poor or non-existing. The same was true for the excretion of o-cresol, which 4 h after exposure was concluded amounted to 0.03-0.26% of the toluene uptake. Thus, after a short-time exposure neither metabolite proved to be a reliable measure of individual toluene uptake at varying workloads or food intake in combination with low exposure levels.
An HPLC technique is described for the analysis of organic acids in lactic acid fermented vegetables. An Aminex HPX-87 column with 0.013 M-H2SO4 as mobile phase was used. Separation data are presented for oxalic, citric, tartaric, malic, succinic, lactic, formic, acetic, propionic, and butyric acids. Interference problems from sugars are also reported.
Proliferative responses of cerebrospinal fluid lymphocytes (CSF-L) and peripheral blood lymphocytes (PBL) from patients with multiple sclerosis (MS) and aseptic meningo-encephalitis (AM) were tested in allogeneic mixed lymphocyte culture (MLC). PBL from various sources (MS, AM, healthy subjects) were used as stimulator cells. CSF-L from 10 of 13 patients with MS and all 15 patients with AM were MLC-reactive to an extent not significantly different from that of PBL. No consistent differences in mixed lymphocyte reaction (MLR) patterns were registered in MS when clinical (exacerbation, age at onset, duration of disease, disability) and CSF variables (mononuclear cell count, CSF IgG index) or presence of HLA Dw2 were considered. The MLC response of PBL obtained from MS and AM patients did not differ significantly from that of healthy individuals. The results contrast with our previous observation of low proliferative response of MS CSF-L to mitogens. Clonal expansion of alloreactive CSF-L offers the possibility of further studies of their characteristics.
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Different methods for the prevention and treatment of vitamin D deficiency were studied in 42 institutionalized elderly people. One group received ultraviolet radiation (UVR) on a large area of the body surface once a week for three months. The results were compared with those in groups receiving either 450 IU vitamin D2 together with 420 mg calcium daily, 420 mg calcium alone, or no treatment. A significant increase in serum 25-hydroxyvitamin D was obtained with UVR. A similar increase was obtained with oral vitamin D2. A small but significant decrease in serum alkaline phosphatase was observed in subjects receiving vitamin D and calcium or calcium alone. No effects on serum phosphate, urinary cyclic adenosine monophosphate and urinary calcium were seen. Though brief UVR at one-week intervals is an efficient and safe method for prevention of vitamin D deficiency in the elderly, it is in our experience time-consuming for the ward staff and thus less convenient than oral vitamin D supplementation.
Enamel changes and caries experience were studied in 134 12-year-old children with a known early exposure to fluoride tablets and/or fluoride containing toothpaste. The influence of birth weight and breast-feeding period was also analyzed. A clinical intact enamel was found in 32% of the children. Enamel fluorosis was found in 45% and localized opacities or hypoplasias in 40%. Children who had consumed fluoride tablets for a period of at least 12 months from the age of 6 months ran a 5.4 times greater risk of developing enamel fluorosis than children with no such consumption. No such risk could be shown in children who at 6 or 12 months of age started to use fluoride toothpaste. There was no statistically significant reduction in the prevalence of smooth surface caries or fillings in children with an exposure to fluoride tablets.
Using the Protein-A plaque assay, numbers of IgG + IgA + IgM producing cells determined in patients with multiple sclerosis (MS) were 0.1-5% in CSF and 0.1-0.7% in peripheral blood; interestingly, 7 of 11 MS patients had IgM producing cells in CSF. In patients with aseptic meningitis (AM), the corresponding values were 0.04-7.5% in CSF and 0.4-2.4% in peripheral blood. There were more Ig producing cells in peripheral blood from patients with AM and MS than in healthy subjects. A correlation between numbers of IgG producing cells in CSF and the concentrations of intrathecally produced IgG (CSF IgG index) was registered in patients with AM; the same was the true for IgA. The Protein-A plaque method, adopted for 20 X 10(3) lymphocytes, makes possible enumeration of Ig-producing cells in CSF and discrimination among cells secreting different Ig classes, thereby being a powerful tool for studying immune reactions in the CNS-CSF compartment.
Atrioventricular and/or intraventricular conduction disturbances were found in 48 (67%) out of 71 patients with familial amyloidosis with polyneuropathy. Low voltage, often described in various forms of heart amyloidosis, was seen in one patient only. Myocardial infarction patterns, also often reported in heart amyloidosis, were not present in our patients. The prevalence of conduction disturbances increased with the duration of the disease. In 28 out of 47 patients from whom more than one ECG recording was available, a progression of conduction disturbances could be seen. Ten patients developed high-degree conduction disturbances and required permanent pacemaker treatment.
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