Acta medica Scandinavica. Supplementum最新文献

{"title":"Lipoprotein lipase, hepatic lipase and plasma lipolytic activity. Effects of heparin and a low molecular weight heparin fragment (Fragmin).","authors":"E Persson","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Heparin activates lipoprotein lipase (LPL) and hepatic lipase (HL), enhances plasma lipolytic activity and elevates plasma levels of free fatty acids (FFA). The metabolic consequences of this effect are controversial. In this study the plasma lipolytic effect of unfractionated heparin (mean molecular weight, MW, 12,000-15,000) was compared with that of a low molecular weight heparin (LMWH) fragment (Kabi 2165, Fragmin, mean MW 4000-6000). The comparisons which were carried out in vivo and in vitro in both man and rat were based on the antifactor Xa activity of the two heparins. After i.v. injection of LMWH the release of LPL activity was only half as great as with heparin and the increase in plasma FFA was significantly lower. The immediate release of HL activity was the same for both heparins, the release of LPL activity was dose-dependent and the elimination followed first-order kinetics. After subcutaneous administration, LMWH was absorbed faster than heparin but still had a negligible effect on plasma lipolysis. With simultaneous i.v. infusions of fat emulsion, glucose and heparin or LMWH to healthy subjects no different effects on fat oxidation were seen in spite of pathological increases in plasma FFA with heparin. Also, heat production from isolated adipocytes was not affected by heparin or LMWH. Enzyme release was greater with LMWH in tissue preparations of fat, skeletal muscle and heart muscle in vitro, however. In isolated fat cells no difference in the release of LPL was seen between the two heparins. In conclusion, the plasma lipolytic effect of LMWH is significantly weaker than that of heparin. The complex-binding between heparin and LPL is dependent on the degree of sulphation or ionic strength of the heparin. In the LPL-release from tissue preparations, the molecular size of the heparin is of greater significance, however. Regardless of the degree of plasma lipolytic activity of the two heparin preparations, the fat oxidation rate is not affected. Considering the toxic effects of high levels of plasma FFA, LMWH, with its weak lipolytic potential would appear to be preferable to heparin as an anticoagulant agent.</p>","PeriodicalId":75385,"journal":{"name":"Acta medica Scandinavica. Supplementum","volume":"724 ","pages":"1-56"},"PeriodicalIF":0.0,"publicationDate":"1988-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13979962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health implications of regional obesity. Proceedings of the fourth Acta Medica Scandinavica International Symposium. Göteborg, Sweden, September 16-18, 1987.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":75385,"journal":{"name":"Acta medica Scandinavica. Supplementum","volume":"723 ","pages":"1-237"},"PeriodicalIF":0.0,"publicationDate":"1988-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14295354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Studies of cardiovascular and renal function in subclinical and manifest diabetic nephropathy.","authors":"J Berglund","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Cardiovascular and Renal function were examined in two populations of long-term insulin-dependent diabetics, those with microalbuminuria, a sign of early, subclinical nephropathy and those with clinically manifest diabetic nephropathy. In addition, clinical variables of possible importance for the occurrence and prognosis of diabetic nephropathy were analyzed. Microalbuminuria - a mean of three over-night urinary albumin excretion rates greater than 20 micrograms/min - was found in 16% of Albustix-negative, normotensive, insulin-dependent diabetics. The microalbuminurics had higher supine blood pressures than normoalbuminurics. The albumin excretion rate in microalbuminurics correlated to blood pressure at rest but not to glycosylated haemoglobin. The cardiovascular responses to five different test manoeuvres revealed more evident signs of autonomic nerve dysfunction in microalbuminurics than in normoalbuminurics. The circulatory reactions during mental stress however, were almost identical in the two subgroups. Despite similar glomerular filtration rate and renal plasma flow the albumin excretion during mental stress increased in microalbuminurics, but remained unchanged in normoalbuminurics. It is postulated that a disturbance of glomerular basement membrane permeability is a pre-requisite for the elevated albumin excretion seen in microalbuminurics. Inability to regulate glomerular haemodynamics, due to autonomic nerve dysfunction, may also be a contributing factor. Such dysfunction perhaps even explains why microalbuminurics have higher blood pressures at rest compared with normoalbuminurics. In manifest diabetic nephropathy the rate of renal functional decline correlated to arterial blood pressure, while glycemic control showed no such relation. Patients with rapidly progressive nephropathy showed higher values of growth hormone than slow progressors. In patients with diabetic renal failure, cardiac catheterization revealed reduced stroke work and elevated left ventricular end-distolic pressure during exercise. Autonomic nerve dysfunction and arterial hypertension possibly contributed to the impaired cardiac performance. The existence of a specific diabetic cardiopathy must even be considered. There was a male predominance both in subclinical and manifest diabetic nephropathy. Age at onset of diabetes was lower in micro- as compared to normoalbuminurics. Duration of diabetes had no prognostic implication in subclinical or manifest nephropathy. The mortality rate was high in patients with manifest nephropathy.(ABSTRACT TRUNCATED AT 400 WORDS)</p>","PeriodicalId":75385,"journal":{"name":"Acta medica Scandinavica. Supplementum","volume":"722 ","pages":"1-69"},"PeriodicalIF":0.0,"publicationDate":"1988-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14294986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Drug utilization in relation to morbidity. Proceedings from a symposium held at the III World Conference on Clinical Pharmacology and Therapeutics. Stockholm, July 27-August 1, 1986.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":75385,"journal":{"name":"Acta medica Scandinavica. Supplementum","volume":"721 ","pages":"1-35"},"PeriodicalIF":0.0,"publicationDate":"1988-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14293009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subcutaneous insulin substitution in insulin-dependent diabetes mellitus. Pharmacokinetic and pharmacodynamic studies.","authors":"P O Olsson","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Determination of free and total insulin with radioimmunoassay, after precipitation of endogenous insulin antibodies with polyethylene glycol, was evaluated. Insulin substitution in insulin-dependent diabetic patients was investigated, embracing the 24 h free insulin and glucose profiles with different regimens, the miscibility of insulin preparations, the overnight metabolic control, and bolus doses of different size with infusion pumps. In the free and total insulin assay precipitation of immunoglobulins with polyethylene glycol was almost complete and the recovery was high. Compared to immediately precipitated and assayed plasma samples at 37 degrees C, free insulin slightly decreased in immediately processed serum (20 degrees C), and also in plasma after 3 h at 20 degrees C. In stored (-20 degrees C) unprecipitated plasma samples free insulin increased after 4 weeks and also in serum samples after 26 weeks, whereas stored PEG-supernates were stable. In healthy controls a low basal insulin was found, increasing about tenfold postprandially. No morning rise in free insulin or glucose was found. The 24 h free insulin profile was strikingly unphysiological with 1 or 2 dose regimens; there was preprandial and nocturnal hyperinsulinaemia but absence of meal-related free insulin peaks. A considerable glucose rise was found after breakfast. Intensive regimens with conventional injections or infusion pumps, gave 24 h free insulin profiles that were similar to the physiological. However, the prandial peaks were retarded; and hyperinsulinaemia was shown with infusion pumps during daytime. An immediate loss of regular insulin was demonstrated after mixture with semisynthetic human lente insulin in vitro and in vivo, but not after mixture with biosynthetic human NPH insulin. The morning glucose control was similar with a bedtime injection of intermediate-acting insulin or continuous subcutaneous insulin infusion, but less hyperinsulinaemia overnight was found with the infusion pump at a constant rate. No early morning glucose rise was demonstrated. Dose-related free insulin profiles were shown after bolus doses with an infusion pump, although they were retarded compared to the physiological postprandial response. The postprandial hyperinsulinaemia was aggravated by continuous subcutaneous insulin infusion. Glucose consumption during euglycaemic clamp corresponded to the free insulin profiles, indicating that free insulin represents the biologically active hormone.</p>","PeriodicalId":75385,"journal":{"name":"Acta medica Scandinavica. Supplementum","volume":"718 ","pages":"1-78"},"PeriodicalIF":0.0,"publicationDate":"1987-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14449389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Calcium antagonism with felodipine in essential hypertension. Effects on cardiovascular and renal function, the sympathetic and the renin-angiotensin-aldosterone systems, glucose tolerance and glucoregulatory hormones.","authors":"P L Katzman","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":75385,"journal":{"name":"Acta medica Scandinavica. Supplementum","volume":"720 ","pages":"1-62"},"PeriodicalIF":0.0,"publicationDate":"1987-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14454815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relation between cardiac dyspnea and left ventricular function. A non-invasive study of 67-year-old men.","authors":"K Caidahl","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The relation of dyspnea of presumed cardiac origin to regional and global left ventricular (LV) function was evaluated among 67-year old men sampled from the general population of Gothenburg, Sweden. From a screened cohort of 644 men, 42 men with cardiac dyspnea and without obstructive pulmonary disease, and 45 controls were sampled. Dyspnea was measured and graded according to the World Health Organization standard. Two-dimensional and M-mode echocardiography, carotid pulse tracing, apexcardiography and phonocardiography were used to evaluate regional wall motion, systolic time intervals, LV ejection indices, wall stress, diastolic time intervals, direct and indirect indices of LV filling properties, and indices of pulmonary hypertension. The plasma concentrations of immunoreactive atrial natriuretic peptide (IrANP) and catecholamines were also assessed. The dyspneic men had more regional wall motion abnormalities than the controls. Systolic, as well as diastolic LV impairment, and increased LV mass were more abundant. Dyspnea grade was significantly related to either of these abnormalities in univariate analyses, and also in multivariate analyses when clinical information, such as chest X-ray, electrocardiogram, and clinical history were taken into account. Multivariate analyses of all the studied indices of cardiac function, together with clinical information, showed dyspnea grade to be significantly and independently related to mitral valve E-point to septal separation (EPSS), presence of akinetic segments, a history of angina pectoris, exercise capacity, and left atrial dimension. Taken together these variables explained 74% of dyspnea grade variance. There was also a relation between dyspnea grade and IrANP, which was independent of clinical findings, but only appeared under conditions of severe dyspnea. It is concluded that the degree of dyspnea is associated with a fairly similar progressive impairment of diastolic, regional and systolic function. In mild heart failure LV hypertrophy and diastolic abnormalities are more prevalent than systolic dysfunction. In severe dyspnea a mixture of regional, systolic, and diastolic abnormalities are present. A decrease of fractional shortening and increased levels of IrANP are late phenomena. EPSS may be a useful indicator of LV dysfunction in population studies.</p>","PeriodicalId":75385,"journal":{"name":"Acta medica Scandinavica. Supplementum","volume":"719 ","pages":"1-62"},"PeriodicalIF":0.0,"publicationDate":"1987-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14098307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Third International Magnus Huss Symposium. Alcohol, brain damage and cardiovascular disease.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":75385,"journal":{"name":"Acta medica Scandinavica. Supplementum","volume":"717 ","pages":"1-113"},"PeriodicalIF":0.0,"publicationDate":"1987-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14603135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fibre and the diabetic diet. An evaluation of the metabolic response to standardized meals.","authors":"B Hagander","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Dietary fibre has a beneficial influence on glucose homeostasis, varying for different fibre sources. Fruit, wheat, rye and beet fibre were studied in isoenergetic meals for NIDD patients and healthy volunteers. The effects of extrusion cooking and flaking were also evaluated. The metabolic response was followed by continuous glucose monitoring and by analyses of pancreatic and gastrointestinal hormones as well as plasma lipid concentrations, For NIDD patients the effects, reflected in the area and the shape of the glucose curve, were greater for the more soluble fibre types, but the insulin and C-peptide responses were largely unaffected by dietary fibre. Beet fibre gave increased somatostatin concentrations also in age-matched healthy controls. They showed, however, unchanged plasma glucose responses and markedly decreased insulin and C-peptide levels. These changes were associated with less pronounced postprandial glycerol reduction, but otherwise none of the fibre preparations affected the postprandial lipemia. Extruded bread, based on wholegrain wheat flour, with high availability of in vitro starch, elicited a greater glucose response than wholegrain wheat bread, associated with a modest increase of GIP and insulin and with a stimulated early glucagon secretion. Flaked rye seemed to contain both faster and slower carbohydrates than the corresponding rye bread of similar fibre content. Analyses of the glucose curves suggested that the effect of fibre might be mediated by an effect on glucose absorption and parallel experiments in rat indicated that a delayed rate of gastric emptying might contribute. Further, the liver glycogen content was higher in rats given a slowly absorbed gastric load. A realistic increase in fibre content, given in long-term treatment, improved the metabolic control in NIDD patients, by decreasing the fasting blood glucose and LDL-cholesterol levels, as well as the LDL/HDL ratio. Hypothetically, slower absorption achieved with dietary fibre increases the proportion of glycogen in the liver. This postprandial improvement may cause the long-term trend to normalization of the fasting blood glucose level.</p>","PeriodicalId":75385,"journal":{"name":"Acta medica Scandinavica. Supplementum","volume":"716 ","pages":"1-55"},"PeriodicalIF":0.0,"publicationDate":"1987-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14026754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biology of vascular disease. Proceedings of the third Acta Medica Scandinavica International Symposium. Stockholm, Sweden, September 6-9, 1986.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":75385,"journal":{"name":"Acta medica Scandinavica. Supplementum","volume":"715 ","pages":"1-171"},"PeriodicalIF":0.0,"publicationDate":"1987-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14598130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}