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Sökning: hsv:(MEDICIN OCH HÄLSOVETENSKAP) hsv:(Klinisk medicin) > (1990-1999) > (1997) > Medicin och hälsovetenskap

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1.
  • Karlsson, Caroline, et al. (författare)
  • 5-Hydroxytryptamine contracts human uterine artery smooth muscle predominantly via 5-HT2 receptors
  • 1997
  • Ingår i: Human Reproduction. - 0268-1161. ; 12:2, s. 361-367
  • Tidskriftsartikel (refereegranskat)abstract
    • Serotonergic receptors were classified in the isolated human uterine artery with intact endothelium, using agonists and antagonists for 5-hydroxytryptamine (5-HT) receptors. The efficacy for different agonists rated: alpha-methyl-5-HT (5-HT2) = 5-HT (non-selective) = 2-methyl-5-HT (5-HT3) >> sumatriptan (5-HT1), and the potency as: sumatriptan = 5-HT > 5-HT > alpha-methyl-5-HT > 2-methyl-5-HT. The contractile effects of 5-HT and alpha-methyl-5-HT were antagonized by the 5-HT2 receptor antagonist ketanserin and the non-selective antagonist methiothepin. The efficacy of sumatriptan was comparatively low. No interaction was encountered between 2-methyl-5-HT and MDL72222, suggesting an absence of 5-HT3 receptors. The results indicate that the contractile serotonergic receptor population in the human uterine artery mainly comprises 5-HT2 receptors, although a minor contribution of contractile 5-HT1 receptors cannot be excluded.
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2.
  • Lindqvist, A, et al. (författare)
  • Artery blood pressure oscillation after active standing up: an indicator of sympathetic function in diabetic patients
  • 1997
  • Ingår i: Clinical Physiology. - : Wiley. - 1365-2281 .- 0144-5979. ; 17:2, s. 159-169
  • Tidskriftsartikel (refereegranskat)abstract
    • Dynamic artery blood pressure (Finapres) response to active standing up, normally consisting of initial rise, fall and recovery above the baseline (overshoot), was compared with the early steady-state artery blood pressure level to measure sympathetic vasomotor function in healthy subjects (n = 23, age 35 +/- 9 years; mean +/-SD) and in type I diabetic patients without autonomic neuropathy (AN) (group 1: n = 18, 38 +/- 13 years), with AN but no cardiovascular drugs (group 2a: n = 7, 44 +/- 11 years) and with both AN and cardiovascular drugs (group 2b: n = 10, 47 +/- 7 years). Systolic and diastolic overshoot were similar in the control (15 +/- 13/15 +/- 11 mmHg) and group 1 subjects. Systolic overshoot disappeared in 57% of patients in group 2a (-1 +/- 9 mmHg; P < 0.03), whereas artery blood pressure still overshot in diastole (8 +/- 7 mmHg; NS). Systolic overshoot disappeared in all patients in group 2b (-22 +/- 22 mmHg; P < 0.0006) and diastolic overshoot disappeared in 60% of these patients (-6 +/- 16 mmHg; P = 0.0006). Systolic early steady-state level was not lower in group 2a than in group 1 (NS), but it was impaired in group 2b (P < 0.006), in which six diabetic patients had a pathological response beyond the age-related reference values. There was a strong association between the overshoot and steady-state levels (P for chi 2 < 0.001, n = 58). Overshoot of the control subjects and patients in group 2b correlated to their respective steady-state blood pressure levels (r > or = 0.76; P < or = 0.001). In conclusion, baroreceptor reflex-dependent overshoot of the artery blood pressure after active standing up diminishes with the development of AN and it is associated with the early steady-state level of the artery blood pressure.
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3.
  • Torffvit, Ole, et al. (författare)
  • The association between diabetic nephropathy and autonomic nerve function in type 1 diabetic patients
  • 1997
  • Ingår i: Scandinavian Journal of Clinical & Laboratory Investigation. - 1502-7686. ; 57:2, s. 183-191
  • Tidskriftsartikel (refereegranskat)abstract
    • Diabetic cardiovascular autonomic neuropathy increases the risk of deterioration in renal function and is associated with increased mortality in patients with renal failure. Type 1 diabetic patients with long diabetes duration, matched for age (38 +/- 9 years) and diabetes duration (28 +/- 8 years) were studied regarding the association between cardiovascular autonomic nerve function and different degrees of diabetic nephropathy. Eighteen patients were normo- (< 30 mg/l), six micro- (30-300 mg/l), and 13 macroalbuminuric (> 300 mg/l) based on urinary albumin concentrations in three separate morning samples. They were compared with 33 control subjects with similar age. Autonomic nerve function was evaluated by measuring the response of heart rate to deep breathing and active standing. Beat-to-beat finger artery blood pressure (Finapres) was tested during active standing. During deep breathing both change in heart rate (17 +/- 11, 9 +/- 7 and 4 +/- 3 beats/min) and ratio between expiratory and inspiratory R-R intervals (1.32 +/- 0.24, 1.14 +/- 0.15 and 1.05 +/- 0.04) decreased from normo- over micro- to macroalbuminuria (p < 0.05 vs normoalbuminuric and control subjects [17 +/- 5 beats/min and 1.28 +/- 0.10, respectively]). Similar results were obtained during active standing with respect to change in systolic arterial blood pressure (3 +/- 8, 2 +/- 13 and -6 +/- 11 mmHg; p < 0.05 vs control subjects [8 +/- 11 mmHg]). However, the response of diastolic arterial blood pressure or mean heart rate to standing up did not differ between any of the groups. The ratio of maximum to minimum R-R interval during the dynamic response of heart rate to active standing decreased with the degree of nephropathy (1.27 +/- 0.17, 1.11 +/- 0.11 and 1.05 +/- 0.06) with significantly higher values in patients with normo- compared with patients with macroalbuminuria (p < 0.05). All patients groups had significantly lower values than control subjects (1.46 +/- 0.22, p < 0.05). The overshoot of the blood pressure after an initial fall during active standing decreased with the degree of diabetic nephropathy. In conclusion, type 1 diabetic patients with long duration of diabetes have signs of cardiovascular autonomic neuropathy, the severity of which is related to the degree of nephropathy.
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4.
  • Hedbrant, Johan, 1959-, et al. (författare)
  • Ny mätmetod för käkmuskulaturen kan finna orsaken till tinnitus : Slutrapport Nutek 92-11904
  • 1997
  • Rapport (övrigt vetenskapligt/konstnärligt)abstract
    • Tinnitus är en åkomma som i lindrigare eller allvarligare former drabbar 17% av västvärldens befolkning. Ca 85 000 svenskar har tinnitus på invalidiserande nivå. Förutom mänskligt lidande orsakar tinnitus samhällskostnader på ca 1.5 miljard kr årligen. Orsaken är till största delen okänd.Vissa tecken tyder på ett samband mellan tinnitus och funktionsstörning i en käkmuskel. Några olika icke–invasiva metoder för mätning av muskelstörning i M Pterygoideus Lateralis har utvärderas. Två av dessa är intressanta för fortsatta studier.Termografi användes för att diagnosticera muskelstörningar på ytligt liggande muskler. Vi såg åtskilliga varma områden på ytliga käk– och nackmuskler på de patienter som hade käkledsstörningar, samt möjligen tecken på onormal värme från M Pterygoideus Lateralis. Mätförhållandena var dock ej ideala.En metod att mäta EMG med adaptiv noise cancelling provades. EMG från en ryggmuskel, stört av en “EKG–signal” från hjärtat användes. Metoden fungerade bra. Fortsatt metodutveckling på t.ex. ryggmuskler borde göras.
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5.
  • Minthon, Lennart, et al. (författare)
  • Somatostatin and neuropeptide Y in cerebrospinal fluid: correlations with severity of disease and clinical signs in Alzheimer's disease and frontotemporal dementia
  • 1997
  • Ingår i: Dementia and Geriatric Cognitive Disorders. - : S. Karger AG. - 1421-9824 .- 1420-8008. ; 8:4, s. 232-239
  • Tidskriftsartikel (refereegranskat)abstract
    • Alzheimer's disease (AD) and frontotemporal dementia (FTD) are the most common types of progressive neurodegenerative disorder in our catchment area. The distribution of cortical degeneration in FTD is mainly the reverse of that in AD, while there are both differences and similarities in the clinical characteristics. Somatostatin and neuropeptide Y (NPY) are neuropeptides with a widespread distribution in the human cerebral cortex. Somatostatin is involved in the regulation of hormone release from the anterior pituitary and may act as a neurotransmitter-modulator. NPY is a potent anxiolytic neuropeptide. Somatostatin and NPY coexist in the cerebral cortex, basal ganglia and in amygdaloid complexes. The present study of AD (n = 34) and FTD (n = 22) analyses the cerebrospinal-fluid (CSF) levels of somatostatin-like immunoreactivity and NPY-like immunoreactivity and correlates their levels to 54 different clinical items, such as restlessness, anxiety, irritability and depression. The CSF levels of the two neuropeptides somatostatin and NPY were significantly correlated in FTD (p < 0.02), but not in AD. Several significant correlations to the clinical signs were found: in AD disorientation and dyspraxia, and in FTD agitation, irritability and restlessness. Somatostatin showed a significant negative correlation with severity of dementia in AD (p < 0.013).
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6.
  • Tisell, Lars-Eric, 1931, et al. (författare)
  • Somatostatin receptor scintigraphy in medullary thyroid carcinoma.
  • 1997
  • Ingår i: The British journal of surgery. - 0007-1323. ; 84:4, s. 543-7
  • Tidskriftsartikel (refereegranskat)abstract
    • 111In-radiolabelled (DTPA-D-Phe1)-octreotide scintigraphy can be used to localize neuroendocrine tumours expressing somatostatin receptors (SSTRs). The aim of this paper was to analyse the importance of tumour volume and growth for the visualization by SSTR scintigraphy of metastases from medullary thyroid carcinoma (MTC).
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7.
  • Bentzer, Peter, et al. (författare)
  • Supersensitivity in rat micro-arteries after short-term denervation
  • 1997
  • Ingår i: Acta Physiologica Scandinavica. - 0001-6772. ; 161:2, s. 125-133
  • Tidskriftsartikel (refereegranskat)abstract
    • Contractile responses to phenylephrine and high-K+ were investigated in vitro in microvascular preparations from the rat medial plantar artery, a branch from the saphenous artery, obtained after short-term denervation in vivo. Two groups of animals were studied: (1) animals undergoing surgical resection of the saphenous nerve, and (2) animals undergoing surgical resection of both the sciatic and saphenous nerves. The animals were operated on one side only. Microvascular preparations (diameter about 325 microns) were obtained 10 days after surgery. Vessels from the non-operated side served as controls. Immunocytochemistry showed a decreased number of both neuropeptide Y (NPY) and calcitonin gene-related peptide (CGRP) immunoreactive nerve fibres in vessels after resection of the saphenous nerve only. Resection of both the saphenous and the sciatic nerve caused a complete loss of immunoreactive nerve fibres. Mechanical measurements were performed using a wire myograph. In vessels subjected to resection of the saphenous nerve the sensitivity to phenylephrine was similar to controls. Vessels denervated by resection of both the saphenous and sciatic nerves showed significant increases in phenylephrine and potassium sensitivity. When depolarized in high-K+ solution the denervated vessels showed an increased sensitivity to extracellular Ca2+. The results show that complete short-term denervation of the rat medial plantar artery in vivo causes a pronounced supersensitivity in the vascular smooth muscle. The supersensitivity appears not to be restricted to the sympathetic alpha-receptors but also associated with changes in the cellular excitation-contraction coupling. Such altered reactivity of the vascular smooth muscle may contribute to vascular disturbances observed in vivo after nerve damage or surgical denervation.
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8.
  • Ivancev, Krassi, et al. (författare)
  • Abdominal aortic aneurysms: experience with the Ivancev-Malmo endovascular system for aortomonoiliac stent-grafts
  • 1997
  • Ingår i: Journal of Endovascular Surgery. - 1074-6218. ; 4:3, s. 242-251
  • Tidskriftsartikel (refereegranskat)abstract
    • PURPOSE: To describe a component-based aortomonoiliac stent-graft system and the first clinical results achieved with this device in endovascular abdominal aortic aneurysm (AAA) repair. METHODS: From November 1993 to October 1996, 45 patients aged 60 to 86 years underwent endoluminal exclusion of true AAAs (median diameter 60 mm) involving the common iliac arteries (median diameter 16 mm right and 15 mm left) using unilimb stent-grafts deployed with the Iancev-Malmo system. RESULTS: Six immediate conversions occurred in the beginning of the series due to endografts that were too short. Complications, including 2 inadvertent renal artery occlusions, 7 kinked grafts, 6 iliac artery dissections, and 3 perioccluder leaks, were prominent features in the first 15 patients. Five patients died in the postoperative period, four of whom were nonsurgical candidates. There were five significant stent-graft migrations: one 3 weeks after surgery due to mechanical injury of the proximal stent and four after 1 year owing to continuous dilation of a wide proximal neck, stent-graft placement in a conical, thrombus-lined proximal neck, and two instances of proximal extension separation from the main graft. Translumbar aneurysm perfusion required embolization in 3 patients. CONCLUSIONS: Despite early complications associated with a learning curve, exclusion of large AAAs using unilimb stent-grafts is feasible. Strict inclusion criteria are necessary in order to improve mortality among nonsurgical candidates and minimize the risk for late migration.
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9.
  • Karlsson, M K, et al. (författare)
  • Remodeling of the spinal canal deformed by trauma
  • 1997
  • Ingår i: Journal of Spinal Disorders. - 0895-0385. ; 10:2, s. 157-161
  • Tidskriftsartikel (refereegranskat)abstract
    • Computed tomography (CT) examinations and functional scores were evaluated in 28 patients with thoracolumbar fractures with intraspinal fragments, of whom 20 underwent operation. The cross-sectional area and the sagittal and frontal diameters of the spinal canal were measured after the injury, postoperatively, and at follow-up (mean, 6 years). The operative reduction significantly increased both diameter and area of the spinal canal. During follow-up, a further significant increase of the sagittal diameter and the area was noted, in both surgically and conservatively treated patients. There was no difference in remodeling between the groups. Six patients in the surgically treated group had neurologic deficits at admission, five had improved, and one remained unchanged at follow-up. The presence or absence of intraspinal fragments should not influence the treatment strategy per se in cases without neurologic signs.
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10.
  • Malina, Martin, et al. (författare)
  • Changing aneurysmal morphology after endovascular grafting: relation to leakage or persistent perfusion
  • 1997
  • Ingår i: Journal of Endovascular Surgery. - 1074-6218. ; 4:1, s. 23-30
  • Tidskriftsartikel (refereegranskat)abstract
    • PURPOSE: To relate changing abdominal aortic aneurysm (AAA) morphology after endovascular grafting to the presence of leakage, collateral perfusion, and other factors. METHODS: Thirty-five patients who underwent successful AAA endovascular grafting were evaluated. Self-expanding Z-stents and Dacron grafts were applied in bifurcated and aortomonoiliac systems. Postoperative diameter changes were calculated from repeated spiral computed tomographic scans, angiograms, and ultrasonic phase-locked echo-tracking scans during a median 6-month follow-up (interquartile range [IQR] 3 to 12). RESULTS: At 12 months, the diameters of completely excluded aneurysms had decreased 6 mm (IQR 2 to 11; p = 0.006). The proximal graft-anchoring stents had dilated 2 mm (IQR 0.5 to 3.3; p = 0.01). The aortic diameters immediately below the renal arteries but above the stents had not changed. Endoleakage and collateral perfusion (n = 13) were each associated with preserved aneurysm size and a 12 times higher risk of aneurysm dilation. After the leakage or the collateral perfusion had been treated, the aneurysm size decreased. Aneurysms with extensive intraluminal thrombi presented a reduced risk of leakage or perfusion. CONCLUSIONS: The diameters of endovascularly excluded AAAs decrease, except in cases of leakage or perfusion. Careful follow-up of patients with aortic endografts is necessary.
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