| 1. |
- Gustavsson, Carl G, et al.
(författare)
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Vein blood rheology alterations immediately after coronary angiography with iohexol, and one month later.
- 1996
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Ingår i: Clinical Hemorheology. - New York, USA : Pergamon Press. - 0271-5198. ; 16:6, s. 737-743
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Tidskriftsartikel (refereegranskat)abstract
- Abstract The effects of coronary angiography with iohexol upon vein blood rheology were studied before, immediately after and one month after angiography. Haematocrit decreased from 40.5 % to 39.0 % immediately after angiography (p < 0.01). When this was compensated for by in vitro standardisation of sample haematocrits to 45% there was a blood viscosity increase by 10.9 - 15.0 %, at the four studied shear rates 0.8 s-1, 2.3 s-1, 19.6 s-1, and 40.0 s-1 (p < 0.05 - p < 0.01). In unadjusted samples, i.e. at the patients natural haematocrits, there was only a slight and statistically non-significant blood viscosity increase. Plasma viscosity decreased immediately after angiography, and was even lower 1 month after angiography. The haematocrit reduction correlated significantly with the iohexol doses (correlation coefficient -0.852, p < 0.001), whereas no significant correlation was found between the contrast volumes and the alterations of blood and plasma viscosity. Except for plasma viscosity, there were no significant differences when the values before angiography and one month later were compared. Key words: Blood viscosity; Contrast media; Iohexol; Coronary angiography; Haematocrit; Haemorheology
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| 2. |
- Alvarsson Jan-Åke, Agüero Oscar, Bretschneider Peter, Brunius Staffan, Gumucio Juan Carlos, Gurt Carl-Johan, Hultkrantz Åke, Isacsson Sven-Erik, Johnsson Mick, Kurkiala Mikael, Liljefors-Persson Bodil, Perruchon Marie & Århem Kaj
(författare)
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Amerikas indiankulturer
- 1997
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Bok (övrigt vetenskapligt/konstnärligt)
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| 3. |
- Engström, Carl-Peter, 1945, et al.
(författare)
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Functional status and well being in chronic obstructive pulmonary disease with regard to clinical parameters and smoking: a descriptive and comparative study.
- 1996
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Ingår i: Thorax. - 0040-6376. ; 51:8, s. 825-30
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Self-assessment questionnaires which measure the functional and affective consequences of chronic obstructive pulmonary disease (COPD) give valuable information about the effects of the disease and may serve as important tools with which to evaluate treatment. METHODS: A cross sectional comparative study was performed between patients with COPD (n = 68), stratified according to pulmonary function, and a healthy control group (n = 89). A battery of well established clinical and quality of life measures (the Sickness Impact Profile (SIP), Mood Adjective Check List (MACL), and Hospital Anxiety and Depression scale (HAD)) was used to examine in which functional and affective aspects the patient group differed from the control group and how these measures related to pulmonary function and smoking habits. RESULTS: Compared with the controls, COPD affected functional status in most areas, not just those requiring physical activity. Forty six patients with forced expiratory volume in one second (FEV1) below 50% predicted showed particularly high levels of dysfunction in ambulation, eating, home management, and recreation/ pastimes (SIP). Despite this, their level of psychosocial functioning and mood status was little different from that of the healthy controls. Among the patients, a subgroup reported substantial psychological distress, but mood status was only weakly, or not at all, related to pulmonary function. Smoking habits did not affect functional status or well being. CONCLUSIONS: Quality of life is not significantly affected in patients with mild to moderate loss of pulmonary function, possibly due to coping and/or pulmonary reserve capacity. This suggests that generic self-assessment questionnaires are of limited value for detecting the early consequences of COPD. However, in later stages of the disease they are sensitive enough to discriminate between patients with different levels of pulmonary dysfunction. The low correlations between the indices of pulmonary function and the indices of affective status suggest that well being depends, to a large extent, on factors outside the clinical domain.
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| 4. |
- Engström, Carl-Peter, 1945, et al.
(författare)
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Long-term effects of a pulmonary rehabilitation programme in outpatients with chronic obstructive pulmonary disease: a randomized controlled study.
- 1999
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Ingår i: Scandinavian journal of rehabilitation medicine. - 0036-5505. ; 31:4, s. 207-13
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Tidskriftsartikel (refereegranskat)abstract
- Fifty patients with severe chronic obstructive pulmonary disease (FEV1 < 50% pred.) were randomized to a rehabilitation group and a control group. The rehabilitation group took part in an individualized multidisciplinary, outpatient 12-month rehabilitation programme. Exercise training was intensive during the first 6 weeks and was then gradually replaced by an individual home-training programme and booster sessions. Controls received the usual outpatient care. Positive effects were found in terms of maximum symptom-limited exercise tolerance and walking distance (13.5 and 12.1% increase, respectively) in the rehabilitation group compared with the controls. Quality of life measurements showed minor beneficial effects on the Sickness Impact Profile, indicating a higher level of activity. No effect was seen on the St George's Respiratory Questionnaire or the Mood Adjective Check List. Patients expressed their enthusiasm for the rehabilitation programme in a study-specific questionnaire.
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| 5. |
- Engström, Carl-Peter, 1945, et al.
(författare)
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Reliability and validity of a Swedish version of the St George's Respiratory Questionnaire.
- 1998
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Ingår i: The European respiratory journal : official journal of the European Society for Clinical Respiratory Physiology. - 0903-1936. ; 11:1, s. 61-6
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Tidskriftsartikel (refereegranskat)abstract
- The St George's Respiratory Questionnaire (SGRQ) was designed to measure quality of life (QoL) in obstructive pulmonary disease. Its reliability, validity and sensitivity have been demonstrated. The aim was to develop a Swedish version of the SGRQ and to confirm its scaling and clinical properties. The SGRQ was adapted for Swedish conditions following a translation-backtranslation procedure. The psychometric and clinical evaluation included 68 patients with chronic obstructive pulmonary disease (COPD). Supplementary QoL, clinical and physiological data were collected. A follow-up study was performed 1 yr later. Correlation analysis used a multitrait-multimethod model. Internal consistency reliability and discriminant validity were documented by performing a multitrait analysis. The results confirmed expected levels of associations. Correlation coefficients between the SGRQ total score and the Sickness Impact Profile Total score (a generic health measure), forced expiratory volume in one second (FEV1) and 6 min walking distance were 0.69, -0.42 and -0.61 respectively. The pattern of correlations in the Swedish data set was very similar to that of the original. The stability of the SGRQ scores was confirmed at follow-up after 1 yr. The reliability was satisfactory, with Cronbach's alpha coefficients >0.80 for the SGRQ and its subdimensions. In conclusion, the Swedish version of the St George's Respiratory Questionnaire is reliable, valid and compares well with the corresponding tests of the original version.
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| 6. |
- Erjefält, Jonas, et al.
(författare)
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Airway epithelial repair: breathtakingly quick and multipotentially pathogenic
- 1997
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Ingår i: Thorax. - 1468-3296. ; 52:11, s. 1010-1012
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Tidskriftsartikel (refereegranskat)abstract
- Epithelial shedding, even to the point of airway denudation, had already been described as a common and unifying feature of asthma by the latter half of the 19th century. However, the repair processes that specifically follow the shedding-like loss of epithelial cells have only recently been examined in vivo. This paper discusses the exceedingly fast epithelial restitution and the potential pathogenic sequelae to epithelial shedding alone that have been unravelled. Epithelial cytoprotection emerges as an important property of future therapeutic drugs for the treatment of airways inflammatory conditions.
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| 7. |
- Erjefält, Jonas, et al.
(författare)
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Allergen-induced eosinophil cytolysis is a primary mechanism for granule protein release in human upper airways
- 1999
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Ingår i: American Journal of Respiratory and Critical Care Medicine. - 1535-4970. ; 160:1, s. 304-312
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Tidskriftsartikel (refereegranskat)abstract
- Cytotoxic eosinophil granule proteins are considered important in the pathogenesis of allergic airway diseases such as rhinitis and asthma. To explore the cellular mechanisms behind eosinophil granule release in human allergic airways, 16 symptom-free patients with seasonal allergic rhinitis were challenged daily with allergen during 1 wk. Nasal lavage samples and biopsies, obtained before and 24 h after the last allergen exposure, were processed for immunohistochemical and electron microscopic analysis. The allergen challenges produced nasal symptoms, marked tissue eosinophilia, and an increase in lavage fluid levels of eosinophil cationic protein (ECP). The nasal mucosa areas with intense extracellular immunoreactivity for ECP were associated with abundant free eosinophil granules. Electron microscopy confirmed the free granules and revealed that all mucosal eosinophils were involved in granule release, either by cytolysis (33%) or piecemeal degranulation (PMD) (67%). Resting or apoptotic eosinophils were not observed. Cytolytic eosinophils had less signs of intracellular granule release (p < 0. 001) and a higher content of intact granules (p < 0.001) compared with viable eosinophils in the same tissue. This study demonstrates eosinophil cytolysis (ECL) as a distinct mechanism for granule mediator release in human allergic airway mucosa. The nature and extent of the ECL and its product (i.e., protein-laden extracellular granules) indicate that allergen-induced cytolysis is a primary and major mechanism for the release of eosinophil proteins in human allergic airway inflammation in vivo.
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| 8. |
- Erjefält, Jonas, et al.
(författare)
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Association between inflammation and epithelial damage-restitution processes in allergic airways in vivo
- 1997
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Ingår i: Clinical and Experimental Allergy. - : Wiley. - 1365-2222 .- 0954-7894. ; 27:11, s. 1344-1355
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Associations between allergen challenge-induced sites of epithelial damage and the distribution of leucocytes and extravasated plasma remain unexplored. OBJECTIVE: To study neutrophils, eosinophils, and fibrinogen at allergen challenge-induced patchy epithelial damage-restitution sites in guinea-pig trachea. METHODS: After local challenge tracheal tissue (cryo sections and whole-mounts) and lumen (selective tracheal lavage) were examined at 1, 5, and 24 h. Eosinophils, neutrophils and fibrinogen were identified by histochemistry. RESULTS: Neutrophils increased markedly in tracheal lavage fluids and in tissue and were strongly associated with the challenge-induced epithelial craters of damage-restitution. At 1 and 24 h eosinophils were increased in the tracheal lumen whereas the surrounding tissue displayed a reversed pattern. Gels rich in fibrinogen, neutrophils, and eosinophils were present in epithelial crater areas, protruding into the lumen. Clusters of free eosinophil granules, Cfegs, released through lysis of eosinophils, and neutrophils with long cytoplasmatic protrusions abounded in these crater areas. CONCLUSION: The present findings provide important new insights into allergic airways where sites of epithelial damage-restitution processes emerge as the major loci for eosinophil, neutrophil, and plasma protein activities, the latter likely causing leukocyte adhesion and activation in vivo. The distribution of eosinophils in this study suggests roles of these cells both in airway mucosa and in regional lymph nodes. Based on the present study we also propose that lysis of eosinophils and Cfegs generation are a major paradigm for activation of these cells in vivo.
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| 9. |
- Erjefält, Jonas, et al.
(författare)
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Effects of topical budesonide on epithelial restitution in vivo in guinea pig trachea
- 1995
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Ingår i: Thorax. - 1468-3296. ; 50:7, s. 785-792
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND--Continuous epithelial shedding and restitution processes may characterise the airways in diseases such as asthma. Epithelial restitution involves several humoral and cellular mechanisms that may potentially be affected by inhaled anti-asthma drugs. The present study examines the effect of a topical steroid on epithelial restitution in vivo in the guinea pig. METHODS--The airway epithelium was mechanically removed from well defined areas of guinea pig trachea without surgery and without damage to the basement membrane or bleeding. An anti-inflammatory dose of budesonide (1 mg) was administered repeatedly to the tracheal surface by local superfusion 24 hours before, at (0 hours), and 24 hours after the denudation. Migration of epithelial cells, formation of a plasma exudation-derived gel, and appearance of luminal leucocytes were recorded by scanning electron microscopy. Cell proliferation was visualised by bromodeoxyuridine immunohistochemistry and tissue neutrophils and eosinophils by enzyme histochemistry. RESULTS--Immediately after creation of the denuded zone ciliated and secretory cells on its border dedifferentiated, flattened out, and migrated speedily (mean (SE) 2.3 (0.3) micron/min) over the basement membrane. After 48 hours the entire denuded zone (800 microns wide) was covered by a tightly sealed epithelium; at this time increased proliferation was observed in new and old epithelium and subepithelial cells. Budesonide had no detectable effect on epithelial dedifferentiation, migration, sealing, or proliferation. Immediately after denudation and continuously during the migration phase plasma was extravasated creating a fibrinous gel rich in leucocytes, particularly neutrophils, over the denuded area. Budesonide had no effect on either the gel or the leucocyte density. CONCLUSIONS--These observations suggest that topical glucocorticoids may not interfere with a fast and efficient restitution of the epithelium in the airways.
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| 10. |
- Erjefält, Jonas, et al.
(författare)
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Epithelial barrier formation by airway basal cells
- 1997
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Ingår i: Thorax. - 1468-3296. ; 52:3, s. 213-217
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Epithelial shedding processes in airway inflammation and defence may produce damaged areas where basal cells are the main remaining epithelial cell type. The present study examines the capacity of basal cells to form an epithelial barrier structure after loss of columnar epithelial cells. METHODS: A technique was developed which allows selective removal of columnar epithelial cells from isolated airways. A drop of tissue adhesive glue was applied on the mucosal surface shortly after excision of guinea pig trachea and human bronchus. Gentle removal of the glue, together with attached columnar cells, left a single layer of cobbled, solitary basal cells. The tissue was kept in culture media. Morphological changes of the basal cells were monitored by immuno-histochemistry and scanning and transmission electron microscopy at several time points. RESULTS: After 20 minutes the basal cells had undergone extensive flattening and established contact with each other. The basement membrane thus became covered by a poorly differentiated epithelium in both guinea pig and human airways. Abundant interdigitating cytoplasmic protrusions were observed at cell borders. CONCLUSIONS: Basal cells promptly flatten out to cover the basement membrane at loss of neighbouring columnar cells. These data may explain why the epithelial barrier function may be uncompromised in desquamative airway diseases. Furthermore, they suggest the possibility that sacrificial release of columnar epithelial cells and prompt creation of a barrier structure constitute important roles of basal cells in airway defence against severe insults.
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