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Biomedical subjects

S Ljunghall

Publications and source records attributed to S Ljunghall.

At least 379 records · Page 21Linked to original sources
PubMed1978

Glucose metabolism in renal stone formers.

Epidemiological studies indicate that renal stone disease is a rapidly increasing problem, already affecting around 10% of the entire adult male population. It has been suggested that environmental factors are responsible for this development, among them particularly disorders of carbohydrate metabolism. In the present study, therefore, 156 patients with active renal stone formation were investigated with respect to glucose tolerance and glucose-stimulated insulin response. Similar to other reports it was found that hypercalciuric subjects had evidence of an impaired glucose metabolism. However, this was mainly attributed to a tendency towards overweight in this group of patients and there were no firm indications of a true disorder of carbohydrate metabolism connected with hypercalciuria or the process of stone formation.

Blood Glucose↗
PubMed1978

Incidence and natural history of renal stone disease and its relationship to calcium metabolism.

In three different general health surveys, including more than 17,000 individuals, the prevalence of renal stone disease was over 10% of all males and 3% of all females. Stones are thus far more common in the population than is generally appreciated from hospital statistics. Each year approximately 1% of the entire adult male population experiences renal stones. This figure appears to increase rapidly and is now at least twice as high as only 20 years ago. Stone formers as a group had a raised urinary excretion of calcium, but were not particularly accumulated in the upper part of the normal urinary calcium distribution. This pattern was generally caused by an intestinal hyperabsorption of calcium, apparently not dependent on the action of parathyroid hormone. The prevalence of stone disease was closely related to the urinary calcium output.

Adult↗
PubMed1978

HLA and kidney stone disease.

Normocalcemic patients with recurring kidney stones were HLA typed. 54 patients with an idiopathic high urinary excretion of calcium but without signs of renal tubular defect showed a B27 phenotype frequency which was more than twice that of the controls and a CW1 frequency that was doubled. After correction for the number of tested HLA specificities the increase was not significant. 35 patients with renal tubular acidosis and 16 patients with no metabolic diagnosis had no deviant HLA antigen distribution.

Acidosis, Renal Tubular↗
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

Bromocriptine therapy in eleven patients with acromegaly.

Eleven patients with active acromegaly were treated with bromocriptine for one year or more. Nine showed significant reduction in plasma growth hormone levels and eight improvement with respect to clinical symptoms. No serious side effects were observed.

Acromegaly↗
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

Renal stones and coronary heart disease.

The relationship between risk factors for coronary heart disease (CHD) and renal stone disease has been studied in a population of more than 2000 middle-aged men. The only positive association found was a slight increase in diastolic BP among stone formers and a higher stone prevalence in untreated hypertensives. Furthermore, the prevalence of a history of renal stones in male survivors of myocardial infarction (MI) was similar to that found in the population study. An investigation of the vitamin D intake by means of a dietary questionnaire revealed no differences between stone formers, healthy controls and MI survivors. Contrary to other reports, the present study indicates that the risk factor profile for CHD in stone formers is similar to that in the general population.

Adult↗
PubMed1975

Epidemiology of renal stones in a middle-aged male population.

The natural history of upper urinary tract stones has been studied retrospectively in 49-50 year-old men in an urban population. The prevalence of stones in 2322 men was found to be 13.7%, with the highest incidence of onset of the disease during fifth decade. Recurrences had occurred in 42% of all cases, the frequency increasing with observation time. On some occasion 23% of the patients had been admitted to hospital and 12.3% had been operated on, 94.5% of all stones passed spontaneously. A family history of kidney stones was significantly more common in stone patients than in healthy controls, and patients with a family history of stones were more prone to early and repeated recurrences. It is suggested that the raised incidence of stone disease in some families may be attributed to environmental rather than genetic factors. This could be of importance for prophylaxis. Analysis of hospital admission rates supported previous findings of a steady rise in stone incidence. The advantages of population studies for comparative analyses are pointed out.

Adolescent↗
PubMedDate not supplied

Surgery for sporadic primary hyperparathyroidism in the elderly.

Retrospective analysis has been performed on 108 consecutive patients operated for primary hyperparathyroidism (HPT) at 75 to 85 years of age (mean 79 years). The preoperative serum calcium value averaged 2.99 mM, and six patients had hypercalcemic crisis. Psychic disturbances were seen in 60 patients (56%), 40% of whom demonstrated dementia. Skeletal and muscular complaints were registered in 29% and 19%, respectively, and only 6% were overtly asymptomatic. Cardiovascular diseases were presented by 69% of the patients, 13% had diabetes mellitus, and 26% were institutionalized prior to surgery. Bilateral neck exploration disclosed a single adenoma in 69%, which was of the oxyphil cell type in 13%, and water-clear (n = 3) or chief cell hyperplasia in 27%. The total glandular weight averaged 1085 mg. Altogether 72 patients operated on after 1980 demonstrated a perioperative (30-day) mortality of 1.4%; the corresponding morbidity of 8.7% mainly included infections as well as a vocal cord paralysis in one patient and two incisional hematomas. Analysis for mean 3.1 years postoperatively displayed reversal of hypercalcemia in 95% of the patients; 2.8% of those operated after 1980 had persistent disease. Symptoms seemed to be alleviated in 62%, with a similar rate attained in patients with dementia. Altogether 60 patients died from mainly cardiovascular diseases mean 4.2 years after the operation. Those succumbing the first postoperative year (n = 21) showed overrepresentation of cardiac diseases and diabetes mellitus. The results demonstrate prevalent psychic disturbances, oxyphil adenomas, and multiglandular parathyroid disease in elderly patients with primary HPT and favor rather liberal application of parathyroid surgery among these individuals.

Aged↗
PubMedDate not supplied

Cellular physiology and pathophysiology of the parathyroid glands.

This report provides insight into parathyroid gland physiology and the pathophysiology of hyperparathyroidism (HPT). Increases in the extracellular calcium concentration constitute the primary physiological signal for inhibition of parathyroid hormone (PTH) release. Transduction of the external signal into a cellular response involves activation of a cation receptor mechanism on the plasma membrane with rapid rise in the cytoplasmic calcium concentration of the cells. This recently discovered parathyroid calcium receptor has been characterized as a glycoprotein of unusually high molecular weight, which may play a key role in calcium homeostasis since it is also expressed in the kidney and placenta. Binding of external calcium to the receptor is associated with mobilization of intracellular calcium as well as calcium influx into the cells and phosphoinositol hydrolysis. These events rapidly interfere with the release process through essentially unknown mechanisms and probably also at sustained stimulation inhibit PTH gene transcription. The relative calcium insensitivity of the PTH release in HPT is associated with a deranged regulation of cytoplasmic calcium within pathological parathyroid cells. The molecular basis for this disturbance comprises down regulation of the cation receptor, whereby external calcium is translated into abnormally low levels of cytoplasmic calcium and insufficient inhibition of PTH release. Studies on expression of the functionally important cation sensing glycoprotein and its associated cellular signal systems may provide novel means for interference with the pathophysiological derangements of HPT.

Animals↗
PubMedDate not supplied

Primary hyperparathyroidism: epidemiology, diagnosis and clinical picture.

Primary hyperparathyroidism (HPT) is a common disorder that mainly afflicts elderly women. It can be diagnosed in at least 1% of all postmenopausal females and autopsy studies indicate an even higher frequency. Although the widespread use of automated serum calcium analyses has increased the awareness of HPT, only 10% of all cases seem to be identified. The diagnosis relies on the demonstration of an inappropriately elevated serum concentration of parathyroid hormone (PTH) relative to the serum calcium value, which need not be markedly raised. Measurements of intact PTH with immunometric methods have considerably improved the diagnostic precision but it is still difficult to evaluate patients with only marginal hypercalcemia. Few patients with diagnosed HPT are completely without symptoms. Symptoms commonly encountered are psychiatric and neuromuscular disturbances. Subclinical bone disease might be relevant but there is insufficient information about its importance in otherwise asymptomatic individuals. Various cardiovascular risk factors appear more commonly in patients with HPT and untreated disease is associated with an increased risk of premature death.

Female↗