| 1. |
|
|
| 2. |
|
|
| 3. |
|
|
| 4. |
|
|
| 5. |
|
|
| 6. |
|
|
| 7. |
|
|
| 8. |
|
|
| 9. |
|
|
| 10. |
|
|
| 11. |
|
|
| 12. |
- Leonardson, L., et al.
(author)
-
Nitrogen Retention in Artificially Flooded Meadows
- 1994
-
In: Ambio: a Journal of Human Environment. - 0044-7447. ; 23:6, s. 332-341
-
Journal article (peer-reviewed)abstract
- Investigations of nitrogen retention in artificially flooded wetlands were performed in southern Sweden during 1991-1993. The purpose of the study was to investigate whether artificial flooding of meadows would be a possible means of reducing the nitrogen content in streams and rivers. Two case studies are presented, one from a sandy/organic soil, one from a peaty soil. Overall nitrogen retention was estimated by mass balance. Denitrification activity and plant biomass incorporation of nitrogen were used to complement and verify the mass-balance data. The study shows that artificial flooding of meadows did not contribute significantly to nitrogen retention in the introduced river water under the irrigation regimes utilized. The technique stimulated mineralization of the soil nitrogen pool to an extent which corresponded to the reduction of nitrate caused by denitrification. In the sandy/organic soil, denitrification was enhanced by the artificial flooding, while in the peat area the activity was lower than in a nonflooded reference area. Plant uptake of nitrogen was stimulated by flooding.
|
|
| 13. |
- Ohlsson, Claes, 1965, et al.
(author)
-
Growth hormone and bone.
- 1998
-
In: Endocrine reviews. - 0163-769X. ; 19:1, s. 55-79
-
Journal article (peer-reviewed)abstract
- It is well known that GH is important in the regulation of longitudinal bone growth. Its role in the regulation of bone metabolism in man has not been understood until recently. Several in vivo and in vitro studies have demonstrated that GH is important in the regulation of both bone formation and bone resorption. In Figure 9 a simplified model for the cellular effects of GH in the regulation of bone remodeling is presented (Fig. 9). GH increases bone formation in two ways: via a direct interaction with GHRs on osteoblasts and via an induction of endocrine and autocrine/paracrine IGF-I. It is difficult to say how much of the GH effect is mediated by IGFs and how much is IGF-independent. GH treatment also results in increased bone resorption. It is still unknown whether osteoclasts express functional GHRs, but recent in vitro studies indicate that GH regulates osteoclast formation in bone marrow cultures. Possible modulations of the GH/IGF axis by glucocorticoids and estrogens are also included in Fig. 9. GH deficiency results in a decreased bone mass in both man and experimental animals. Long-term treatment (> 18 months) of GHD patients with GH results in an increased bone mass. GH treatment also increases bone mass and the total mechanical strength of bones in rats with a normal GH secretion. Recent clinical studies demonstrate that GH treatment of patients with normal GH secretion increases biochemical markers for both bone formation and bone resorption. Because of the short duration of GH treatment in man with normal GH secretion, the effect on bone mass is still inconclusive. Interestingly, GH treatment to GHD adults initially results in increased bone resorption with an increased number of bone-remodeling units and more newly produced unmineralized bone, resulting in an apparent low or unchanged bone mass. However, GH treatment for more than 18 months gives increased bone formation and bone mineralization of newly produced bone and a concomitant increase in bone mass as determined with DEXA. Thus, the action of GH on bone metabolism in GHD adults is 2-fold: it stimulates both bone resorption and bone formation. We therefore propose "the biphasic model" of GH action in bone remodeling (Fig. 10). According to this model, GH initially increases bone resorption with a concomitant bone loss that is followed by a phase of increased bone formation. After the moment when bone formation is stimulated more than bone resorption (transition point), bone mass is increased. However, a net gain of bone mass caused by GH may take some time as the initial decrease in bone mass must first be replaced (Fig. 10). When all clinical studies of GH treatment of GHD adults are taken into account, it appears that the "transition point" occurs after approximately 6 months and that a net increase of bone mass will be seen after 12-18 months of GH treatment. It should be emphasized that the biphasic model of GH action in bone remodeling is based on findings in GHD adults. It remains to be clarified whether or not it is valid for subjects with normal GH secretion. A treatment intended to increase the effects of GH/IGF-I axis on bone metabolism might include: 1) GH, 2) IGF, 3) other hormones/factors increasing the local IGF-I production in bone, and 4) GH-releasing factors. Other hormones/growth factors increasing local IGF may be important but are not discussed in this article. IGF-I has been shown to increase bone mass in animal models and biochemical markers in humans. However, no effect on bone mass has yet been presented in humans. Because the financial cost for GH treatment is high it has been suggested that GH-releasing factors might be used to stimulate the GH/IGF-I axis. The advantage of GH-releasing factors over GH is that some of them can be administered orally and that they may induce a more physiological GH secretion. (ABSTRACT TRUNCATED)
|
|
| 14. |
|
|
| 15. |
|
|
| 16. |
|
|
| 17. |
- Arnestad, J P, et al.
(author)
-
Removal of activated complement from shed blood: comparison of high- and low-dilutional haemofiltration.
- 1998
-
In: Acta anaesthesiologica Scandinavica. - 0001-5172. ; 42:7, s. 811-5
-
Journal article (peer-reviewed)abstract
- BACKGROUND: Perioperative blood salvage is associated with release of inflammatory mediators. Depending on type of processing, the complement system is activated to some extent in the final blood product. The aim of the present study was to evaluate a haemofiltration technique concerning complement system activation and whether the volume of added saline will have an influence on the elimination of activated complement during processing. METHODS: Sixteen patients undergoing total hip arthroplasty received wound blood salvaged intraoperatively with a haemofiltration technique. Saline was added to the reservoir for washing in a ratio of 1:1 or 5:1 of estimated blood volume. Samples for determination of the anaphylatoxins C3a and C5a, and the terminal SC5b-9 complement complex (TCC) were drawn from the patients, the collected blood, the ultrafiltrate and the processed blood. RESULTS: Increased concentrations of C3a, C5a and TCC were found in aspirated and processed blood. Haemofiltration did not reduce the concentrations of these factors, except that of C3a in the group where saline was added in a ratio of 5:1. There were no increased concentrations of C3a, C5a or TCC in the patient plasma after reinfusion. No differences in blood pressure, heart rate, pH, arterial oxygen tension, arterial carbon dioxide tension, or base excess were found in association with reinfusion of the blood. CONCLUSION: Collected shed blood washed through haemofiltration contained moderately elevated concentrations of C3a, C5a and TCC. Reinfusion of the blood neither led to increased systemic concentrations of complement activation products, nor to disturbances in haemodynamic or biochemical parameters.
|
|
| 18. |
- Bengtsson, Anders, 1954, et al.
(author)
-
Extracorporeal ("ex vivo") connection of pig kidneys to humans. III. Studies of plasma complement activation and complement deposition in the kidney tissue.
- 1998
-
In: Xenotransplantation. - 0908-665X. ; 5:3, s. 176-83
-
Journal article (peer-reviewed)abstract
- The complement system is one of the important factors involved in the hyperacute rejection of xenografts. This report deals with the activation of the complement system in a clinical trial where pig kidneys were extracorporeally connected to two volunteer dialysis patients who were pretreated with plasmapheresis in order to substantially reduce anti-pig xenoantibodies. The clinical data of the perfusion experiments and the patients humoral immune response to pig xenoantigens have been reported in detail (Xenotransplantation 1996; 3:328-339, 340-353). Three consecutive daily plasmapheresis treatments of the patients reduced the plasma complement protein (C3, C4, and C5) concentrations to 8-27% of the baseline values. The perfusion of the pig kidney connected to patient 1 was terminated at 65 min due to graft rejection and this patient was not hemodynamically affected by the experiment. The second experiment was terminated at 15 min due to an anaphylactic like reaction of the patient. In patient 1 a slight reduction of plasma C3, C4, and C5 and an increase of C5a and SC5b-9 occurred, while C3a decreased during the perfusion. Patient 2 had an increase of all complement parameters, most prominent for C4d and SC5b-9, which occurred concomitant with the appearance of the anaphylactic like side effects. In general, plasma levels of PMN elastase, IL6 and IL8 increased in both patients during the perfusion. Immunohistochemical investigation of the kidney tissues revealed deposition of human complement factors C1q, C4c, and C3c in a congruent pattern with the vasculature of the kidney in patient 1. In kidney 2 only trace amounts of C1q and C3c were found. Both kidneys were negative for properdin. Therefore, in this experimental set up with extracorporeal connection of pig kidneys to the human circulation the human complement cascade is activated mainly through the classical pathway.
|
|
| 19. |
- Bengtsson, A, et al.
(author)
-
The appropriateness of performing coronary angiography and coronary artery revascularization in a Swedish population
- 1994
-
In: Journal of the American Medical Association (JAMA). - : American Medical Association. - 0098-7484 .- 1538-3598. ; 271:16, s. 1260-1265
-
Journal article (peer-reviewed)abstract
- Objective. —To evaluate the appropriateness of performing coronary angiography and revascularization in a Swedish population. Design. —Prospective population study of questionnaires and medical records. Setting. —All the hospitals in southwestern Sweden that perform coronary angiography and revascularization. Patients. —Random sample of 831 patients (with chronic stable angina) on the waiting list for coronary angiography or revascularization in southwestern Sweden in September 1990. Main Outcome Measure. —Percentage of patients referred for coronary angiography or revascularization for appropriate, uncertain, or inappropriate indications. Results. —Of the patients referred for angiography, 89% were classified as appropriate, 9% as uncertain, and 2% as inappropriate. The percentages are similar for patients referred for coronary artery bypass graft surgery and for angioplasty (91% and 86%, respectively, classified as appropriate). The majority of patients had chest pain rated as Canadian Cardiovascular Society classes II through IV (93%), despite maximum anti-ischemic therapy in 90% of these patients. Conclusions. —Few patients were referred for coronary angiography or revascularization for inappropriate or uncertain indications. The percentage of these patients who are from southwestern Sweden is similar to the percentage recently reported from New York State.
|
|
| 20. |
- Bengtsson, A, et al.
(author)
-
The epidemiology of a coronary waiting list. A description of all patients
- 1994
-
In: Journal of Internal Medicine. - : Wiley-Blackwell Publishing Ltd.. - 0954-6820 .- 1365-2796. ; 235:3, s. 263-269
-
Journal article (peer-reviewed)abstract
- Keywords: cardiac symptoms; chest pain; coronary revascularization; delay; ischaemic heart disease; nervous reactions; waiting list Abstract. Objectives. To describe the characteristics and the severity of symptoms amongst patients on the waiting list for possible coronary revascularization. Design. All the patients were sent a postal questionnaire for symptom evaluation. Setting. All hospitals in western Sweden. Subjects. All patients in western Sweden on the waiting list in September 1990, who had been referred for coronary angiography or revascularization (n = 904) and a sex- and age-matched reference group (n = 809). Results. More than half of the patients had daily attacks of chest pain, whereas 16% reported less than one attack per week or no pain at all. However, other symptoms such as dyspnoea, tachycardia and nervous reactions were also common and 25% of all patients used sedatives. A long waiting time for a given procedure was not associated with more pain but with more nervous symptoms such as restlessness and insomnia (P < 0.0001) and greater use of sedatives and cigarettes (P < 0.05). Conclusions. We conclude that a long waiting time for possible coronary revascularization is associated with more nervous symptoms but not with more pain.
|
|
| 21. |
|
|
| 22. |
|
|
| 23. |
|
|
| 24. |
- Bengtsson, H, et al.
(author)
-
Prevalence of abdominal aortic aneurysm in the offspring of patients dying from aneurysm rupture
- 1992
-
In: British Journal of Surgery. - : Oxford University Press (OUP). - 1365-2168 .- 0007-1323. ; 79:11, s. 1142-1143
-
Journal article (peer-reviewed)abstract
- The prevalence of abdominal aortic aneurysm (AAA) is high in the brothers of patients with aneurysm. A genetic component in the development of AAA has, therefore, been postulated. In this study the offspring of patients who had died from AAA rupture were invited to undergo ultrasonography of the abdominal aorta. The attendance rate was 69 per cent. Thirty-nine sons of median age 60 (range 45-75) years and 23 daughters of median age 62 (range 42-80) years were examined. Abdominal aortic dilatation was found in eight men and one woman. The presence of aortic dilatation in these nine cases was not related to age, hypertension, smoking or symptoms of occlusive arterial disease. It is concluded that the sons of those who have died from ruptured AAA constitute a high-risk group for the development of this condition and should be considered for further screening.
|
|
| 25. |
|
|
| 26. |
|
|
| 27. |
- Bengtsson, Lars, et al.
(author)
-
Cold climate hydrology in Sweden
- 1994
-
In: Northern Hydrology International Perspectives. ; NHRI Science 3, s. 109-127
-
Book chapter (peer-reviewed)
|
|
| 28. |
- Bengtsson, Lars, et al.
(author)
-
Environmental effects of river ice in Sweden
- 1993
-
In: Proceedings of the 9th International Northern Research Basins Symposium/Workshop : 14-22 August 1992, Whitehorse, Dawson City, Eagle Plains, Yukon, Inuvik, Northwest Territories - 14-22 August 1992, Whitehorse, Dawson City, Eagle Plains, Yukon, Inuvik, Northwest Territories. - 0660147653 ; 2, s. 875-884
-
Book chapter (peer-reviewed)
|
|
| 29. |
|
|
| 30. |
|
|
| 31. |
- Bengtsson, T., et al.
(author)
-
Actin dynamics in human neutrophils during adhesion and phagocytosis is controlled by changes in intracellular free calcium
- 1993
-
In: European Journal of Cell Biology. - Jena, Germany : Urban und Fischer Verlag. - 0171-9335 .- 1618-1298. ; 62:1, s. 19-58
-
Journal article (peer-reviewed)abstract
- The role of changes in cytosolic free calcium concentration ([Ca2+]i) in the assembly and disassembly of actin during adhesion and phagocytosis was evaluated. Rhodamine-phalloidin staining combined with quantitative fluorescence and confocal laser scanning microscopy was used to measure local F-actin changes in single adherent human neutrophils phagocytosing yeast particles on different surfaces and under different calcium conditions. Cells were suspended in a) calcium-containing medium (CCM) or b) calcium-free medium (CFM) or c) were first depleted of calcium (i.e., MAPT/AM-loaded in CFM) and then suspended in CFM (MAPT). In parallel, local [Ca2+]i changes were monitored using a fura-2 ratio imaging system. In CCM or CFM, attachment to the substrate and formation of pseudopods around a yeast particle generated, within a few seconds, rises in [Ca2+]i, both around the phagosome and in the cell body. During continued phagocytosis, [Ca2+]i was more elevated around the phagosome compared to the rest of the cell. No [Ca2+]i fluctuations were observed in MAPT cells. Adhesion and phagocytosis led to a several-fold increase in F-actin. The increase was transient in cells in CCM and CFM, but remained high in Ca-depleted neutrophils. A distinct ring of F-actin was formed around a phagosome with a yeast particle. Twenty min after ingestion the amount of this actin decreased more than 50% in CCM and CFM cells but increased by 40 to 100% in MAPT cells. The accumulation of F-actin in MAPT cells was reduced to resting levels by adding Ca2+ and ionomycin after ingestion. This treatment reestablished the periphagosomal [Ca2+]i rises, as observed in CCM cells. In conclusion, the present study shows that the actin polymerization, occurring in human neutrophils during adhesion and phagocytosis, is not influenced by changes in [Ca2+]i, whereas the subsequent depolymerization is. The accumulation of actin filaments around the phagosome in calcium-depleted cells could be involved in the inhibition of phagolysosome fusion seen in the absence of [Ca2+]i changes (Jaconi et al., J. Cell Biol. 110, 1555-1564 (1990)). This suggests that the actin network, controlled by [Ca2+]i, regulates the movement of granules during phagocytosis.
|
|
| 32. |
- Breimer, Michael, 1951, et al.
(author)
-
Extracorporeal ("ex vivo") connection of pig kidneys to humans. I. Clinical data and studies of platelet destruction.
- 1996
-
In: Xenotransplantation. - : Wiley. - 0908-665X .- 1399-3089. ; 3:4, s. 328-39
-
Journal article (peer-reviewed)abstract
- The pioneering experiment by Welsh et al. (Immunological Lett 1991:29:167-170) connecting a pig kidney to the human circulation has been repeated in a modified manner. Two volunteer dialysis patients were pretreated by daily plasmapheresis on days -2,-1, and 0 to remove the naturally occurring anti-pig xenoantibodies. The anti-pig lymphocytotoxic liters were reduced from 1:8 to 1:2 in patient 1 and from 1:8 to 1:1 in patient 2. No steroids or immunosuppressive drugs were administrated before or during the experiments. A sterile pig kidney was extracorporeally ("ex vivo") connected to the patients a/v fistula using an arterial and a venous pump similar to a dialysis. The two experiments gave different results. In the first experiment the perfusion pressure was kept at 100 mmHg for the initial 25 min by reducing the pump speed until the minimum blood flow of 30 ml/min was reached. Thereafter, the pressure rose continuously and the experiment was terminated at 65 min at a perfusion pressure of 200 mmHg. The patient did not feel any discomfort during the perfusion. In the second experiment, a stable blood flow of 200 ml/min was reached at a pressure of 100 mmHg after a few minutes. The perfusion was terminated at 15 min when the patient developed chest and abdominal pain, hypotension, and electrocardiographic signs of myocardial ischemia. The patient recovered quickly. In the first experiment, small volumes of clear urine was produced until the pressure rose above 100 mmHg, which resulted in hematuria. In the second experiment clear urine (4 ml/min) was produced. (51)Chromium clearance values were after 15 min <1 ml/min for kidney 1 and 12 ml/min (8 ml/min/100 g) for kidney 2. A drastic reduction in platelet count (128 to 48 and 64 to 8 × 10(9)/1, respectively) during the passage through the kidney was found in blood samples collected simultaneously before and after the organ. No change in hemoglobin values and leucocyte counts were found. Light- and electron-microscopical analysis of the kidney tissues revealed for kidney 1 focal areas with obliteration of the glomerular and peritubular capillaries by platelets and PMN cells and severe damage of the endothelial cells comparable to a picture of a hyperacute rejection. In kidney 2, all vessels were patent but in the capillaries large amount of membrane fragments were detected by electron microscopy and a discrete damage of the endothelial cells were seen in some segments. No intact platelets were present in the vascular tree. These human experiments support the hypothesis that hyperacute rejection of pig to human xenografts is delayed in time by removal of the preformed anti-pig xenoantibodies. A new finding was a very rapid destruction of platelets occurring in the kidney of patient 2 who had very low liters of xenoantibodies. The humoral immune response is described in detail in an accompanying paper (Rydberg et al., this issue).
|
|
| 33. |
|
|
| 34. |
|
|
| 35. |
|
|
| 36. |
- Ericsson, Per, 1968, et al.
(author)
-
Bonded Al2O3-covered Si-wafers for highly thermally conductive SOI-materials
- 1998
-
In: Proceedings of the Fourth International Symposium on Semiconductor Wafer Bonding: Science, Technology, and Applications. ; , s. 576-
-
Conference paper (peer-reviewed)abstract
- Aluminum oxide films deposited by low temperature atomic layer epitaxy were studied as an alternative to the commonly used silicon dioxide buried insulator of bonded silicon on insulator wafers. Successful room temperature bonding was performed between bare hydrophilic silicon wafers and silicon wafers covered with aluminum oxide. The surface energy after room temperature bonding was 50 mJ/m2, and after an anneal at 330°C, it had increased to 600 mJ/m2. After annealing at 500°C, the silicon wafers fractured upon insertion of a 50 μm blade. Higher temperatures than 500°C resulted in wafer separation, probably due to film densification and associated tensile stress. Leakage currents through the aluminum oxide films and breakdown electric fields were satisfactory for the intended application after a post-deposition anneal
|
|
| 37. |
|
|
| 38. |
- Hansson, L, et al.
(author)
-
Predictors of subjective quality of life in schizophrenic patients living in the community. A Nordic multicentre study.
- 1999
-
In: International Journal of Social Psychiatry. - 0020-7640 .- 1741-2854. ; 45:4, s. 247-58
-
Journal article (peer-reviewed)abstract
- As part of a Nordic multi-centre study investigating the life and care situation of community samples of schizophrenic patients the aim of the present part of the study was to examine the relationship between global subjective quality of life and objective life conditions, clinical characteristics including psychopathology and number of needs for care, subjective factors such as satisfaction with different life domains, social network, and self-esteem. A sample of 418 persons with schizophrenia from 10 sites was used. The results of a final multiple regression analysis, explaining 52.3% of the variance, showed that five subjective factors were significantly associated with global subjective quality of life, together with one objective indicator, to have a close friend. No clinical characteristics were associated with global subjective quality of life. The largest part of the variance was explained by satisfaction with health, 36.3% of the variance, and self-esteem, 7.3% of the variance. It is concluded that the actual relationship between objective life conditions and subjectively experienced quality of life still remains unclear. Furthermore, it seems obvious that personality related factors such as self-esteem, mastery and sense of autonomy also play a role in the appraisal of subjective quality of life, which implies that factors like these are important to consider in clinical and social interventions for patients with schizophrenia in order to improve quality of life for these persons.
|
|
| 39. |
- Henderson, M., et al.
(author)
-
Lifetimes of the 5d ^{9} 6p levels in Hg III
- 1999
-
In: Physical Review A. Atomic, Molecular, and Optical Physics. - 1050-2947 .- 1094-1622. ; 59:5, s. 4068-4070
-
Journal article (peer-reviewed)abstract
- We report measurements and theoretical calculations for the lifetimes of the 5d96p levels in Hg iii with J=0,2,3,4. This is an extension of earlier measurements of the lifetimes of the 5d96p levels in Hg iii with J=1, and now provides data for all 12 of the levels. The results also provide an isoelectronic comparison with earlier studies of these levels in Au ii of the Pt sequence, and a homologous comparison with earlier studies of the 4d95p levels in Ag ii, Cd iii, and In iv in the Pd sequence.
|
|
| 40. |
- Hultin, M, et al.
(author)
-
Release of lipoprotein lipase to plasma by triacylglycerol emulsions. Comparison to the effect of heparin.
- 1992
-
In: Biochimica et Biophysica Acta. - 0006-3002 .- 1878-2434. ; 1125:1, s. 97-103
-
Journal article (peer-reviewed)abstract
- It was previously known that lipoprotein lipase (LPL) activity in plasma rises after infusion of a fat emulsion. To explore the mechanism we have compared the release of LPL by emulsion to that by heparin. After bolus injections of a fat emulsion (Intralipid) to rats, plasma LPL activity gradually rose 5-fold to a maximum at 6-8 min. During the same time the concentration of injected triacylglycerols (TG) decreased by about half. Hence, the time-course for plasma LPL activity was quite different from that for plasma TG. The disappearance of injected 125I-labelled bovine LPL from circulation was retarded by emulsion. This effect was more marked 30 min than 3 min after injection of the emulsion. The data indicate that the release of LPL into plasma is not solely due to binding of the lipase to the emulsion particles as such, but involves metabolism of the particles. Emulsion increased the fraction of labelled LPL found in adipose tissue, heart and the red muscle studied, but had no significant effect on the fraction found in liver. The effects of emulsion were quite different from those of heparin, which caused an immediate release of the lipase to plasma, decreased uptake of LPL in most extrahepatic tissues by 60-95%, and increased the fraction taken up in the liver.
|
|
| 41. |
- Hustad, J.E., et al.
(author)
-
Reactivity measurements of coke particles in five different flow reactors
- 1990
-
In: Rivista dei Combustibili. - 0370-5463. ; 44:10, s. 257-267
-
Journal article (other academic/artistic)abstract
- Experiments on reactivity of 128 μm coke particles in the gas temperature range from 1150 K to 1370 K have been performed in five different flow reactors in the Nordic countries and all the results were calculated by the shrinking particle model. The activation energy is found to be 25 kcal/mol indicating combustion control by the combined effects of chemical kinetic and pore diffusion (zone II combustion). The overall apparent reaction order was found to be 1.0
|
|
| 42. |
|
|
| 43. |
|
|
| 44. |
|
|
| 45. |
|
|
| 46. |
- Johannsson, Gudmundur, 1960, et al.
(author)
-
Effects of 1 year of growth hormone therapy on serum lipoprotein levels in growth hormone-deficient adults. Influence of gender and Apo(a) and ApoE phenotypes.
- 1995
-
In: Arteriosclerosis, thrombosis, and vascular biology. - 1079-5642. ; 15:12, s. 2142-50
-
Journal article (peer-reviewed)abstract
- We investigated the influence of gender and apoE and apo(a) phenotypes as well as the effect of the metabolic effects of growth hormone (GH) on the effect of GH therapy on serum lipoprotein concentrations in GH-deficient (GHD) adults. Forty-four consecutive patients, 30 men and 14 women aged 46.5 (range, 19 to 76) years with GHD due mainly to pituitary tumors, were treated with recombinant human GH for 12 months. Serum concentrations of lipoproteins, insulin, thyroxine, and insulin-like growth factor-I were determined, body composition was assessed by bioelectrical impedance, and apo(a) and apoE phenotypes were analyzed. Lipoprotein(a) [Lp(a)] concentrations in the GHD subjects were compared with a gender- and apo(a) phenotype-matched control group. After 12 months of GH treatment, the total cholesterol, LDL cholesterol, and apoB concentrations decreased, the HDL cholesterol and apoE concentrations increased, and the apoA-I and triglyceride concentrations were unchanged. Before treatment, the Lp(a) concentration was similar to that in the control group. However, after 12 months of treatment, the Lp(a) concentration had increased by 44% and 101% above baseline and the control group, respectively. Men and women responded differently to GH, with a more marked increase in Lp(a) concentration and fat-free mass and a more pronounced decrease in body-fat mass in men. Apo(a) phenotypes had no major influence on the effect of GH therapy. The only significant difference between apoE phenotypes was a higher baseline Lp(a) concentration among apoE4 heterozygotes.(ABSTRACT TRUNCATED AT 250 WORDS)
|
|
| 47. |
|
|
| 48. |
- Johannsson, Gudmundur, 1960, et al.
(author)
-
Individualized dose titration of growth hormone (GH) during GH replacement in hypopituitary adults.
- 1997
-
In: Clinical endocrinology. - 0300-0664. ; 47:5, s. 571-81
-
Journal article (peer-reviewed)abstract
- Until now, GH treatment in GH-deficient adults has employed dose schedules of GH based on body weight or body surface area and has ignored individual responsiveness to GH. This trial has studied the effects of an individualized GH dose adjusted to match a combination of clinical response, normalization of serum IGF-I concentration and body composition.Two closely-matched groups, each comprising 30 GH-deficient adults, 38 men and 22 women aged 48 years, were treated with GH for 12 months. The high dose (HD) group received a target dose of 12 micrograms/kg per day and the individualized dose (ID) group received an initial daily GH dose of 0.17 or 0.33 mg per day (0.5 and 1 IU, respectively), independent of body weight, with dose adjustments thereafter.Serum concentrations of IGF-I, lipoprotein(a), insulin, calcium, intact PTH, osteocalcin and blood glucose were measured. Body composition was determined according to a 4-compartment model using total body potassium and tritiated water as input variables. Total body nitrogen was measured by in vivo neutron activation and total body bone mineral content by dual energy X-ray absorptiometry.At 12 months, the daily dose of GH was 0.55 +/- 0.03 mg and 0.45 +/- 0.03 mg in the HD and ID groups, respectively (P < 0.05). In the HD group, the mean serum IGF-I increased to levels well above the predicted level, while in the ID group the mean serum IGF-I normalized. Side-effects were experienced by 70% of the subjects in the HD group and by 30% in the ID group (P < 0.001). A similar response to GH in terms of body composition, glucose homeostasis, lipoprotein(a) and blood pressure was obtained in both treatment groups. However, the treatment response in terms of serum calcium, intact PTH and osteocalcin was more marked in the HD group.Similar efficacy, with a lower dose of GH and fewer side-effects, was obtained by considering individual responsiveness to GH as compared to higher doses of GH adjusted to match body weight.
|
|
| 49. |
|
|
| 50. |
|
|
