| 1. |
- Nilsson, Ola, 1957, et al.
(författare)
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Growth factors and carcinoid tumours.
- 1993
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Ingår i: Acta oncologica (Stockholm, Sweden). - 0284-186X. ; 32:2, s. 115-24
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Tidskriftsartikel (refereegranskat)abstract
- The presence of growth factors and their receptors in human midgut carcinoids and in gastric carcinoids of Mastomys have been investigated. Human midgut carcinoid tumours produce IGF-I as demonstrated by immunocytochemistry and radioimmunoassay. IGF-I receptors were detectable in half of the tumours and stimulation of cultured tumour cells with IGF-I enhanced DNA synthesis. IGF-I may therefore act as an autocrine stimulator of carcinoid tumour growth. Expression of TGF-alpha and EGF-receptors could also be demonstrated in midgut carcinoids by immunocytochemistry and Northern analysis, suggesting that TGF-alpha participates in the autocrine modulation of carcinoid growth. Co-culture of human midgut carcinoid tumours and rat fetal cholinergic neurons demonstrated secretion of a potent neuronotrophic factor by cultured tumour cells. IGF-I and TGF-alpha may account for these neuronotrophic effects, but carcinoid tumours may also secrete an as yet unidentified growth factor. Gastric (ECL cell) carcinoids developed rapidly in Mastomys during hypergastrinemia due to histamine2-receptor blockade, suggesting that gastrin is an essential growth factor for these carcinoids.
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| 2. |
- Eggertsen, Robert, 1948, et al.
(författare)
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Effect of coffee on ambulatory blood pressure in patients with treated hypertension.
- 1993
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Ingår i: Journal of internal medicine. - : Wiley. - 0954-6820 .- 1365-2796. ; 233:4, s. 351-5
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Tidskriftsartikel (refereegranskat)abstract
- Effects of caffeine on ambulatory blood pressure, heart rate, renin-angiotensin system, and ANP were studied in patients treated for mild to moderate hypertension in a randomized, double-blind, placebo-controlled, cross-over trial comparing 2 weeks of caffeine-free diet with 2 weeks of regular coffee use. Twenty-three patients (13 men; aged 28-74 years) with treated, mild to moderate essential hypertension and a regular intake of 3-4 cups of coffee daily completed the study. Mean 24-h, day- or night-time ambulatory blood pressure and heart rate were not different between regimens. Nor were there any effects on the renin-angiotensin system while ANP was significantly increased during caffeine intake. Compliance of the dietary regimen was excellent as assessed by serum caffeine concentration measurements. We conclude that habitual coffee drinking did not influence the 24-h blood pressure profiles or cardiovascular hormones in treated hypertensives.
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| 3. |
- Eggertsen, Robert, 1948, et al.
(författare)
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The value of screening for retinopathy and microalbuminuria in patients with type 2 diabetes in primary health care.
- 1993
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Ingår i: Scandinavian journal of primary health care. - : Informa UK Limited. - 0281-3432 .- 1502-7724. ; 11:2, s. 135-40
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Tidskriftsartikel (refereegranskat)abstract
- Patients with type 2 diabetes (NIDDM) attending the Primary Care Centre in Mölnlycke, Sweden, were evaluated regarding their metabolic status, microalbuminuria (UAER), and hypertension. An ophthalmological examination was performed, and two diagnostic methods, slit-lamp biomicroscopy and fundus photography, were compared. Nearly half the patients (42%) had diabetic retinopathy, mainly of the background type. Retinopathy was associated only with the duration of the disease, but the prevalence was as high as 20% within 0-4 years of the diagnosis. Fundus photography was easy to apply, except in the age groups above 80 years, in otherwise healthy and mentally cooperative patients. Fundus photography could not be applied in only 7% of the patients for ophthalmological reasons. The prevalence of microalbuminuria (20-200 micrograms/min) was high--34%--with another 8% above that range. Male sex, mode of antidiabetic treatment, and hypertension were associated with an increased UAER. Screening for retinopathy and microalbuminuria is valuable in primary health care in order to detect treatable diabetic retinopathy and to trace patients with microalbuminuria, a risk factor for clinically overt nephropathy as well as for cardiovascular diseases.
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| 4. |
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| 5. |
- Frisén, Lars, 1939
(författare)
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High-pass resolution perimetry. A clinical review.
- 1993
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Ingår i: Documenta ophthalmologica. Advances in ophthalmology. - 0012-4486. ; 83:1, s. 1-25
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Forskningsöversikt (refereegranskat)abstract
- Review of all available reports comparing high-pass resolution perimetry (HRP) and conventional perimetry in normals and in subjects with different visual disorders reveals closely comparable aspects of sensitivity, specificity, and reliability. HRP shows important advantages concerning variability, test duration, and subject preferences. Drawbacks seem largely limited to somewhat loose renditions of visual field defects of small area and large depth. Otherwise HRP's novel format of graphic result presentation may be better suited to visual evaluation than conventional gray-scale maps with their lumping of thresholds and extensive interpolations. Several examples are provided of visual field defects due to various lesions throughout the visual system.
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| 6. |
- Lindqvist, Göran, 1923, et al.
(författare)
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Normal Pressure Hydrocephalus: Psychiatric Findings Before and After Shunt Operation Classified in a New Diagnostic System for Organic Psychiatry.
- 1993
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Ingår i: Acta Psychiatrica Scandinavica Suppl. - 0065-1591. ; 373, s. 18-32
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Tidskriftsartikel (refereegranskat)abstract
- 23 patients with normal pressure hydrocephalus (NPH) underwent psychiatric examinations prior to and 80 days to 10 months after a ventriculo-peritoneal shunt operation. A global evaluation of the effect of the operation on the patients' mental symptoms indicated appreciable improvement in 10 cases and slight improvement in a further 4. 8 patients were assessed as unchanged, and one as mentally deteriorated. The psychiatric analyses was based on a new diagnostic system created by two of the authors (G.L., H.M.). The patients manifested varying, often complex psychiatric symptom constellations with symptomatological components from two or more organic mental disorders. Before the operation a mild or a moderately severe somnolence-sopor-coma disorder (SSCD) was diagnosed in 10 cases. After the operation all these patients became free from symptoms of SSCD. This was the most unequivocal change in connection with the operation, and the elimination of all symptoms of SSCD was the single factor which most effectively contributed to the total therapeutical result in these patients. All 23 cases were considered to have symptoms of a more or less severe astheno-emotional disorder (AED) preoperatively. The degree of severity of this disorder could not be determined with satisfactory certainty in some of the patients with complex symptoms. Amongst the 17 cases where the preoperative symptomatology allowed for a reasonably precise calculation of the degree of severity of AED, 6 were assessed as markedly improved after the operation and 10 as largely unchanged. In one patient, symptoms of the AED increased when the postoperative course was complicated by a subdural haematoma. Symptoms of an emotional-motivational blunting disorder (EMD) were diagnosed in 5 cases before the operation. After the operation 3 of these patients were symptom free in this respect while 2 were unchanged. Slight or moderately severe symptoms of Korsakoff's amnestic disorder (KAD) were before the operation found in 7 cases: at the postoperative examination 6 of these cases were improved, of which 4 were free from such symptoms; one was unchanged. According to our experience, confident prognoses concerning the effect of the shunt operation on symptoms of SSCD can be made preoperatively, while, for a particular patient, the therapeutic effect on AED, EMD and KAD is often difficult, or sometimes impossible, to foresee. This article contains three case reports which represent different forms and courses of the mental symptom patterns.
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| 7. |
- Malmgren, Helge, 1945, et al.
(författare)
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Organic Mental Disorders as Hypothetical Pathogenetic Processes.
- 1993
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Ingår i: Acta Psychiatrica Scandinavica Suppl.. - 0065-1591. ; 373, s. 5-17
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Tidskriftsartikel (refereegranskat)abstract
- A new diagnostic system for organic psychiatry is presented. We first define "organic psychiatry", and then give the theoretical basis for conceiving organic-psychiatric disorders in terms of hypothetical psychopathogenetic processes, HPP:s. Such hypothetical disorders are not strictly identical to the clusters of symptoms in which they typically manifest themselves, since the symptoms may be concealed or modified by intervening factors in non-typical circumstances and/or in the simultaneous presence of several disorders. The six basic disorders in our system are Astheno-Emotional Disorder (AED), Somnolence-Sopor-Coma Disorder (SSCD), Hallucination-Coenestopathy-Depersonalisation Disorder (HCDD), Confusional Disorder (CD), Emotional-Motivational Blunting Disorder (EMD) and Korsakoff's Amnestic Disorder (KAD). We describe their usual etiologies, their typical symptoms and course, and some forms of interaction between them.
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| 8. |
- Nilsson, O, et al.
(författare)
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Rapid induction of enterochromaffinlike cell tumors by histamine2-receptor blockade.
- 1993
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Ingår i: The American journal of pathology. - 0002-9440. ; 142:4, s. 1173-85
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Tidskriftsartikel (refereegranskat)abstract
- The effect of acid inhibition on gastric endocrine cells was investigated in Praomys (Mastomys) natalensis. Long-term treatment (1 to 32 weeks) with an irreversible histamine 2-receptor blocker (loxtidine) caused a sustained increase in plasma gastrin levels, which was accompanied by a gradual increase in histamine and histidine decarboxylase activity of the gastric oxyntic mucosa. The density of endocrine cells in the oxyntic mucosa increased gradually, doubled by 8 weeks, and was three times that of controls after 24 weeks of treatment. Hyperplastic changes in the endocrine cell population were evident after 2 to 8 weeks in all animals, whereas dysplastic or neoplastic lesions were observed in half the animals after 16, 24, and 32 weeks of treatment. Gross tumors in the oxyntic mucosa were observed in 1/4 of the animals treated for 24 or 32 weeks. Proliferating cells were identified as enterochromaffinlike cells because they were argyrophilic and immunopositive for chromogranin A and histamine. The results demonstrate that histamine 2-receptor blockade initiated by loxtidine promotes a rapid development of enterochromaffinlike cell tumors in Mastomys and suggest a critical role for gastrin in the formation of these tumors. However, the rate and frequency by which carcinoid tumors appeared in Mastomys after acid inhibition was much greater than that reported in other species, indicating that several factors, including hormonal and genetic factors, are important in the development of gastric endocrine tumors.
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| 9. |
- Wängberg, Bo, 1953, et al.
(författare)
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Embolisation therapy in the midgut carcinoid syndrome: just tumour ischaemia?
- 1993
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Ingår i: Acta oncologica (Stockholm, Sweden). - 0284-186X. ; 32:2, s. 251-6
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Tidskriftsartikel (refereegranskat)abstract
- Forty-eight patients with midgut carcinoid tumours and disseminated disease were treated at our unit 1986-1991. All patients underwent primary surgery with optimal tumour reduction. Twenty-seven patients with bilobar liver metastases had subsequent embolizations of the hepatic arteries to further reduce the functional tumour mass and were thereafter treated with a low dose of octreotide. The response to this treatment was evaluated by CT at 3 months postembolization. The patients could then be divided into 13 responders (no visible hepatic tumours or more than 50% reduction, group I) and 14 non-responders (less than 50 reduction or progression, group II). When these patients were studied biochemically and in terms of prognosis, the reduction of 5-HIAA levels postembolization was much more pronounced in group I (80 +/- 3%) then in group II (28 +/- 12%). The biochemical and radiological responses were long-lasting in group I, none of the patients needed further ischaemic treatment. Of specific interest were 3 patients with bilobar disease, who after selective unilobar embolisation normalised their 5-HIAA levels and had bilateral tumour regression. These findings indicate involvement of systemic effects in addition to tumour ischaemia alone. The initial biochemical response with marked decrease of 5-HIAA levels in combination with tumour regression may thus serve as an indicator of good prognosis.
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| 10. |
- Ahlman, Håkan, 1947, et al.
(författare)
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Adrenocortical carcinoma--diagnostic and therapeutical implications.
- 1993
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Ingår i: The European journal of surgery = Acta chirurgica. - 1102-4151. ; 159:3, s. 149-58
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Tidskriftsartikel (refereegranskat)abstract
- To evaluate the results of treatment of a consecutive series of patients with adrenocortical carcinoma who presented during the six year period 1985 to 1991.
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