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Sökning: hsv:(MEDICIN OCH HÄLSOVETENSKAP) hsv:(Klinisk medicin) > (1990-1999) > (1994) > Lunds universitet

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1.
  • Minthon, Lennart, et al. (författare)
  • Tacrine treatment modifies cerebrospinal fluid neuropeptide levels in Alzheimer's disease
  • 1994
  • Ingår i: Dementia (Switzerland). - : S. Karger AG. - 1013-7424. ; 5:6, s. 295-301
  • Tidskriftsartikel (refereegranskat)abstract
    • Biochemical and histochemical studies have demonstrated a widespread deficit in the activity of acetylcholinesterase (AChE) in the brains of patients with Alzheimer's disease (DAT). Multiple disturbances in several transmitter systems have been found. The most consistent neurochemical changes in DAT are reductions in the cholinergic system. The major pharmacological approach today in DAT is based on the cholinergic theory assuming that acetylcholine has a major cortical impact on cognitive processes. Tetrahydroaminoacridine (THA, tacrine) is a centrally active reversible acetylcholinesterase inhibitor. A large number of trials have been performed in patients with DAT. This article was to evaluate whether THA treatment induced neuropeptide alteration in DAT before and after 1 year on oral THA treatment.
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2.
  • Lindgren, Arne, et al. (författare)
  • Electrocardiographic changes in stroke patients without primary heart disease
  • 1994
  • Ingår i: Clinical Physiology. - 1365-2281. ; 14:2, s. 223-231
  • Tidskriftsartikel (refereegranskat)abstract
    • Consecutive electrocardiograms were recorded in 28 stroke patients without signs of primary heart disease. Individuals with subarachnoidal haemorrhage, or electrolyte disturbances were excluded. A computerized tomography of the brain was performed in each case and showed a cerebral haemorrhage (n = 4), cortical infarction (n = 6), subcortical infarction (n = 14) and normal finding (n = 4). One patient developed atrial fibrillation but no other case of serious disturbances in rate of rhythm occurred. None developed AV block, bundle branch blocks or significant changes in QRS complexes. The most common abnormalities in ECG were transient STT changes in lateral leads, which were seen in 13 cases. The typical findings were flat or slightly negative T waves, horizontal or down-sloping ST segments and sometimes a small ST depression. In no case did ECG show typical signs of acute myocardial infarction. A transient prolonged QT interval was seen in three patients and transient U waves in four. ECG did not correlate to the location of the vascular lesion seen on CT or the clinical outcome. It is concluded that STT changes of a small magnitude are seen in about half of the cases of stroke patients without primary heart disease and that they do not resemble the typical pattern of acute myocardial ischaemia.
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3.
  • Ohlin, Acke, et al. (författare)
  • Complications after transpedicular stabilization of the spine. A survivorship analysis of 163 cases
  • 1994
  • Ingår i: Spine. - 0362-2436. ; 19:24, s. 2774-2779
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVES. The authors studied complications of transpedicular stabilization methods. SUMMARY OF BACKGROUND DATA. One hundred and sixty-three consecutive transpedicular stabilization procedures were performed between January 1987 and December 1991. The indications for stabilization were trauma (33 cases), metastatic spinal disorder (30 cases), spinal stenosis (33 cases), spondylolisthesis (27 cases), ankylosing spondylitis (6 cases), low back pain (22 cases), and miscellaneous (12 cases). METHODS. Patients records and the entire series of radiographs for each case were scrutinized by independent observers. All per- and postoperative complications, including implant loosening and fatigue, were recorded. Clinical and radiographic survivorship analyses of the implants were performed. RESULTS. Early complications were unusual and none were associated with permanent morbidity. The probability of not having the implant removed in the first postoperative year was 85%. There was a 40% risk of radiographic failure, defined as loosening or implant fatigue, at 6 months. The outcome was more favorable in cases in which anterior vertebral interbody fusion was also performed. CONCLUSIONS. Transpedicular fixation is a safe procedure with a low incidence of serious per- and early postoperative complications. The mechanical durability of transpedicular fixators used alone is a cause for concern.
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4.
  • Edvinsson, Lars, et al. (författare)
  • Neuropeptide Y in sympathetic co-transmission: recent advances in the search for neuropeptide Y antagonists
  • 1994
  • Ingår i: Pharmacology and Toxicology. - 1600-0773. ; 74:4-5, s. 193-201
  • Tidskriftsartikel (refereegranskat)abstract
    • Since the discovery of neuropeptide Y which is co-stored and co-operate with noradrenaline (NA) in sympathetic nerve fibers, several scientific groups have searched for structures with neuropeptide Y antagonistic properties. Research has mainly focused on various peptide fragments which originate from or are related to the neuropeptide Y sequence. Some non-peptide antagonists have been proposed but they are mostly of low potency and non-selective. Our recent observations that alpha-trinositol (D-myo-inositol 1.2.6-trisphosphate) is an inhibitor of neuropeptide Y effects will hopefully lead to the development of useful non-peptide neuropeptide Y inhibitors. As a novel approach the highly selective approach of down-regulating neuropeptide Y receptors with antisense oligodeoxynucleotides is also discussed. Neuropeptide Y antagonistic agents would help us to understand the physiological role of neuropeptide Y and may serve as useful medication in circulation disorders.
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5.
  • Agardh, Elisabet, et al. (författare)
  • A 5-year follow-up study on the incidence of retinopathy in type 1 diabetes mellitus in relation to medical risk indicators
  • 1994
  • Ingår i: Journal of Internal Medicine. - 1365-2796. ; 235:4, s. 353-358
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVES. The aim of the present study was to describe the 5-year incidence of retinopathy in type 1 diabetes mellitus and to characterize risk indicators for the development and progression of retinopathy. DESIGN. A cross-sectional study of type 1 diabetic patients taken care of at a medical department. SETTING. All type 1 diabetic patients attending the Department of Internal Medicine, University Hospital, Lund, during a 2-year period were offered ophthalmological examination. SUBJECTS. A total of 396 out of 461 (85.9%) initially examined type 1 diabetic patients formed the basis for this 5-year follow-up study. MAIN OUTCOME MEASURES. The degree of retinopathy was based on fundus photography or biomicroscopy. Degree of metabolic control was assessed by HbA1c levels, signs of nephropathy by albumin creatinine clearance ratio and urinary albumin levels. Blood pressure was measured in the supine position. Duration of diabetes, age, and insulin dosage were registered. RESULTS. The incidence of retinopathy was 47.2% and progression from background to severe retinopathy occurred in 41%. Risk indicators for the development of retinopathy were duration of diabetes (P < 0.001), degree of metabolic control (P < 0.001), insulin dosage (P < 0.05) and signs of nephropathy based on measurements of albumin creatinine clearance ratio (P < 0.01) and urinary albumin concentration (P < 0.05). Two risk indicators could be identified for progression of retinopathy, i.e. the degree of metabolic control (P < 0.01) and diastolic blood pressure (P < 0.05). CONCLUSIONS. The results suggest that apart from poor metabolic control, development of retinopathy in type 1 diabetes is associated with long diabetes duration and clinical signs of diabetic nephropathy. Progression of retinopathy is associated with poor metabolic control and elevated diastolic blood pressure levels.
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6.
  • Buckwalter, J. A., et al. (författare)
  • Operative treatment of osteoarthrosis
  • 1994
  • Ingår i: Journal of Bone and Joint Surgery. American Volume. - 0021-9355. ; 76:9, s. 1405-1418
  • Tidskriftsartikel (refereegranskat)
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7.
  • Elfgren, C., et al. (författare)
  • Neuropsychological tests as discriminators between dementia of Alzheimer type and frontotemporal dementia
  • 1994
  • Ingår i: International Journal of Geriatric Psychiatry. - : Wiley. - 1099-1166 .- 0885-6230. ; 9:8, s. 635-642
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of this study was to examine whether cognitive test performance alone could distinguish patients with dementia of Alzheimer type (DAT) from those with frontotemporal dementia (FTD). Scores from three neuropsychological tests were used as discriminating variables in 28 cases with postmortem verified diagnoses. The selected tests measured verbal ability, visuospatial ability and verbal memory. Eighty-nine per cent of the sample was correctly classified by discriminant analysis. Evaluating the ability of the obtained discriminant function to differentiate between groups of DAT and FTD in a new, clinically diagnosed sample of 38 cases yielded an overall success rate of 84%. The results suggest that cognitive tests may be helpful for differential diagnosis in the context of a neuropsychiatric examination.
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8.
  • Elmstahl, S., et al. (författare)
  • Quantitative EEG in elderly patients with Alzheimer's disease and healthy controls
  • 1994
  • Ingår i: Dementia (Switzerland). - : S. Karger AG. - 1013-7424. ; 5:2, s. 119-124
  • Tidskriftsartikel (refereegranskat)abstract
    • Multichannel (19) EEG were analyzed in 23 female patients with rather advanced late-onset Alzheimer's disease (AD) and compared with 56 age- and sex-matched healthy control subjects. The quantified EEG was correlated with psychometric and clinical variables. The control subjects showed increasing theta activity with age but the EEG changes did not correlate significantly with psychometric features. The AD patients showed highly significant increases in delta and theta activity and decreases in beta activity compared with controls. The EEG changes were most marked over posterior regions of the brain. The individual EEG variables showed a high degree of intercorrelation and an almost complete discrimination between patients and controls was accomplished by taking only the posterior delta activity into account. In a subgroup of 10 patients, in which a Mini Mental test score could be obtained, the score correlated with the relative theta power.
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9.
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10.
  • Kimblad, Per Ola, et al. (författare)
  • Eliminating the strong pulmonary vasoconstriction caused by Euro-Collins solution
  • 1994
  • Ingår i: Annals of Thoracic Surgery. - 1552-6259. ; 58:3, s. 728-733
  • Tidskriftsartikel (refereegranskat)abstract
    • Single-flush perfusion with Euro-Collins solution (ECS), after pretreatment with prostaglandin E1 or prostacyclin, is at most centers the standard procedure for preservation of lungs for transplantation. In a previous study, we showed that the high potassium content of ECS causes strong pulmonary vasoconstriction at temperatures higher than 20 degrees C. In the present study, five drugs used as pretreatment and added to the perfusate were compared for their ability to counteract ECS-induced constriction of porcine pulmonary arteries: papaverine reduced the vasoconstrictive effect by 92% +/- 4%; nifedipine, by 62% +/- 6%; the thromboxane A2 receptor antagonist daltroban, by 15% +/- 4%; and prostaglandin E1, by 12% +/- 4%. On the other hand, prostacyclin not only failed to reduce ECS-induced vasoconstriction but at the highest concentration tested, enhanced it by 37% +/- 7%. The combination of papaverine (10(-4) mol/L) and nifedipine (10(-6.5) mol/L) was the only pretreatment to abolish ECS-induced vasoconstriction; moreover, it has no adverse effect on endothelial function. Neither prostaglandin E1 nor prostacyclin effectively counteracts ECS-induced vasoconstriction, though they may have other beneficial effects.
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