| 1. |
- Torffvit, Ole, et al.
(author)
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Urine and serum levels of the carboxyterminal domain (NCl) of collagen IV in membranous glomerulonephritis and diabetic nephropathy
- 1991
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In: Nephron. - 0028-2766. ; 59:1, s. 15-20
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Journal article (peer-reviewed)abstract
- Serum and urinary concentrations of NCl, the non collagenous globular domain of collagen IV, were used as markers for turnover of basement membranes. NCl levels were studied in membranous glomerulonephritis and diabetic nephropathy. Thirteen patients with membranous glomerulonephritis and 8 insulin-dependent diabetic patients with diabetic nephropathy were compared to 16 apparently healthy control subjects. The patients with membranous glomerulonephritis had lower levels of NCl in serum and urine compared to the control subjects. In comparison, the patients with diabetic nephropathy had similar levels of NCl in serum and urine as the control subjects. Furthermore, among patients with membranous glomerulonephritis, those with hypertension had higher serum levels of NCl than those without, which may indicate that hemodynamic factors influence the basement membrane collagen metabolism. It is suggested that there are differences in basement membrane turnover in membranous glomerulonephritis and diabetic nephropathy although there are similarities in glomerular histopathological features. Other possible mechanism are discussed. Further studies are needed to confirm the suggested mechanism.
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| 2. |
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| 3. |
- Torffvit, Ole, et al.
(author)
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A study of exercise-induced microalbuminuria in type I (insulin-dependent) diabetes mellitus
- 1991
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In: Scandinavian Journal of Urology and Nephrology. - : Informa UK Limited. - 0036-5599 .- 1651-2065. ; 25:1, s. 39-43
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Journal article (peer-reviewed)abstract
- Microalbuminuria is thought to be an important prognostic factor in diabetes mellitus. To study the influence of changes in blood pressure on the development of microalbuminuria during exercise, two exercise tests were carried out. A total of 32 insulin dependent diabetic men whose age at onset was less than 30 years, mean duration of diabetes 14 years (range 7 to 21) and mean age 29 years (range 21 to 40), and who did not have albuminuria (N-labstix negative) were studied. The diabetic patients were compared with a total of 29 age-matched male control subjects. Urinary albumin excretion was measured during two exercise tests: at a standardised workload (150 W) for 30 min, and at a standardised heart rate for 25 min. The diabetic patients had higher albumin excretion rates during both exercise tests compared with the control subjects. Blood pressure and heart rate during exercise were significantly higher in diabetic patients compared with control subjects in the standardised workload test. If the test was individualised to achieve the same standardised heart rate there was no significant difference in blood pressure between the diabetic patients and the control subjects. These results indicate that the diabetic kidneys were more sensitive than the healthy kidneys to similar degrees of haemodynamic stress induced by exercise.
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| 4. |
- Torffvit, Ole, et al.
(author)
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Albuminuria and associated medical risk factors: a cross-sectional study in 451 type II (noninsulin-dependent) diabetic patients. Part 2
- 1991
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In: Journal of Diabetic Complications. - 0891-6632. ; 5:1, s. 29-34
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Journal article (peer-reviewed)abstract
- The association between urinary albumin concentration (UAC) in a morning urine sample and medical risk factors was evaluated in a cross-sectional study of 451 type II (noninsulin-dependent) diabetic patients. The following four groups of patients were created according to their urinary albumin levels: A) normal (less than 12.5 mg/L); B) high normal (12.5-30 mg/L); C) microalbuminuria, ie, incipient nephropathy (31-299 mg/L); and D) clinical nephropathy (greater than or equal to 300 mg/L). The patients with high normal levels had higher HbA1c and systolic blood pressure levels than patients with values within normal limits. The prevalence of incipient and clinical diabetic nephropathy was 20 and 7%, respectively. Incipient nephropathy was associated with higher blood pressures and body weights. Patients with clinical nephropathy had even further increases in these parameters, were older, and had longer duration of diabetes. In both groups of nephropathy, men were preponderant. Thirty six percent of all patients and 73% of patients with clinical nephropathy were treated for hypertension; 55% were treated with insulin. The insulin-treated patients had poorer metabolic control, but there were no differences in blood pressure or serum creatinine levels as compared with those of patients not receiving insulin treatment. The proportion of patients with severe retinopathy increased with the degree of albuminuria, although 22% of the patients with clinical nephropathy continued to be nonretinopathic.
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| 5. |
- Torffvit, Ole, et al.
(author)
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Albuminuria and associated medical risk factors: a cross-sectional study in 476 type I (insulin-dependent) diabetic patients. Part 1
- 1991
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In: Journal of Diabetic Complications. - 0891-6632. ; 5:1, s. 23-28
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Journal article (peer-reviewed)abstract
- Albumin concentration in a morning urine sample was analyzed in a cross-sectional study in 476 insulin-dependent diabetic patients. The following groups of patients were defined: A) normal urinary albumin (urine albumin less than 12.5 mg/L); B) high normal albuminuria (12.5-30 mg/L); C) microalbuminuria, ie, incipient nephropathy (31-299 mg/L); and D) clinical nephropathy (greater than or equal to 300 mg/L). The prevalences of incipient and clinical diabetic nephropathy were 24.8 and 14.4%, respectively. There were no differences in clinical parameters such as age, age at onset or duration of diabetes, blood pressure, serum creatinine, or HbA1c levels between groups A and B. The frequency of retinopathy in these groups was 55 and 50%, respectively. In group C, there were increases in age, duration of diabetes, blood pressure, serum creatinine, and HbA1c levels. The frequency of retinopathy was higher (80%), and more patients had severe forms (47%). In group D, there were further increases in all parameters and, in addition, younger age at onset of diabetes. The frequency of retinopathy was 97%, and severe forms of retinopathy were more common (86%). Seventeen percent of the patients were treated for hypertension. These patients were older, had longer duration of diabetes, and had higher levels of blood pressure, serum creatinine, and urinary albumin, as well as a younger age at onset of diabetes than patients not requiring antihypertensive treatment.
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| 6. |
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| 7. |
- Bodelsson, Mikael, et al.
(author)
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Differential effect of hypothermia on the vascular tone and reactivity of the human coronary artery and graft vessels
- 1991
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In: Journal of Cardiovascular Surgery. - 0021-9509. ; 32:3, s. 288-294
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Journal article (peer-reviewed)abstract
- Hypothermia may contribute to vascular spasm during bypass surgery. The effect of cooling on the reactivity of the human coronary artery (CA), saphenous vein (SV) and internal mammary artery (IMA) was studied in vitro. In CA and IMA cooling diminished the resting tension and the contraction to potassium, noradrenaline and 5-hydroxytryptamine. In contrast, in SV the contraction to noradrenaline and 5-hydroxytryptamine was augmented by cooling. The effect of cold was reversible. These results demonstrate different effects of hypothermia in CA and the graft vessels. Thus, hypothermia augments the receptor-mediated contraction in SV but depresses it in IMA which thereby resembles CA. The difference is most marked in the contractile response to 5-hydroxytryptamine, which may accumulate during surgery. This may contribute to spasm in the saphenous vein grafts and may be involved in the mechanisms responsible for the inferior patency of SV compared to IMA as a graft vessel.
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| 8. |
- Hellström-Westas, Lena, et al.
(author)
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Cerebral function monitoring during the first week of life in extremely small low birthweight (ESLBW) infants
- 1991
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In: Neuropediatrics. - 0174-304X. ; 22:1, s. 27-32
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Journal article (peer-reviewed)abstract
- In order to evaluate the usefulness of early continuous EEG-monitoring in very preterm neonates, recordings with a Cerebral Function Monitor (CFM) were made prospectively in 31 ESLBW infants with birthweights below 901 grams, during their first week of life. The CFM background activity was, as expected from EEG studies, dominated by a suppression-burst pattern in 94% of the infants. Some infants had periods with more continuous EEG activity or suppression-burst changing into continuous. Patterns similar to sleep-wake cycling (SWC) were identified in infants with gestational ages as low as 24 weeks. The level of the CFM-background activity was mainly influenced by the presence and severity of intracranial hemorrhage (ICH), but also by medications such as phenobarbital. Epileptiform activity (EPA) was only found in infants with ICH, and was identified in 75% of these infants. Of the infants with EPA, 87% had periods with subclinical EPA, although 47% had both clinical and subclinical seizures. The presence of more continuous activity and SWC were indicators of a favourable outcome, whereas electrocerebral inactivity predicted an unfavorable outcome. The prognostic estimates of mortality and neurologic outcome were similar for early CFM recording (positive predictive value 69-100%) and cranial ultrasound scan (positive predictive value 71-100%). The monitoring of cerebral electrical activity also provided immediate and clinically useful information during the intensive care of these ESLBW infants. Further studies on the causal relation between EPA and the development of ICH should be performed before definite conclusions can be drawn concerning any preventive effect from anticonvulsive treatment of clinical/subclinical seizures.
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| 9. |
- Henze, A C, et al.
(author)
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Aplasia of the right aortic cusp in a neonate : a life-threatening but curable anomaly
- 1991
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In: Annals of Thoracic Surgery. - 0003-4975. ; 52:6, s. 30-1329
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Journal article (peer-reviewed)abstract
- A case of absent right aortic cusp causing serious aortic incompetence in a neonate is reported. A "bicuspidalization" repair broke down within 24 hours, but reoperation with annular enlargement and insertion of a 19-mm prosthetic valve resulted in complete recovery. This rare but life-threatening anomaly of the aortic valve can be recognized with Doppler echocardiography. Valve replacement in conjunction with aortic annular enlargement should be performed as primary repair.
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| 10. |
- Kimblad, Per Ola, et al.
(author)
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High potassium contents in organ preservation solutions cause strong pulmonary vasocontraction
- 1991
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In: Annals of Thoracic Surgery. - 1552-6259. ; 52:3, s. 523-528
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Journal article (peer-reviewed)abstract
- Euro-Collins (ECS) and UCLA-formula organ preservation solutions induced strong vasocontraction in porcine pulmonary arteries when studied in organ baths at temperatures of 37 degrees C and 30 degrees C. At 20 degrees C ECS induced a 30% contraction, but at 6 degrees C no contraction (n = 5) or a weak contraction (n = 1) was elicited. Neither prostaglandin E1 nor nifedipine caused any significant reduction of the vasocontraction elicited by ECS and UCLA. Krebs solution, enriched with potassium in amounts corresponding to those in ECS (115 mmol/L) or UCLA (30 mmol/L), induced vasocontraction comparing well with those induced by ECS or UCLA, indicating that it is the high potassium content that causes the vasocontraction. In a second experiment lung segments were stored at 4 degrees C for 9 hours in ECS, UCLA, or Krebs solution. Pulmonary arterial segments were then studied in organ baths at 37 degrees C. The choice of preservation solution did not significantly affect the contractile properties of potassium, noradrenaline, or the thromboxane mimic U-46619. To conclude, high potassium contents in organ preservation solutions induce strong pulmonary vasocontraction in lung temperatures greater than 20 degrees C but not in temperatures less than 10 degrees C. These vasocontractions are not significantly reduced by prostaglandin E1 or nifedipine. We suggest that the initial preservation solution used to cool down the lungs should contain 4 mmol/L or no potassium. When the lung temperature is less than 10 degrees C, a second perfusion might be done, and then a high potassium content (if thought to be essential) will not cause vasocontraction.
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