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Biomedical subjects

A Alm

Publications and source records attributed to A Alm.

At least 73 records · Page 4Linked to original sources
PubMed1989

Prostaglandin F2 alpha-isopropylester eye drops: effects in normal human eyes.

The effects of PGF2 alpha-isopropylester eye drops on intraocular pressure (IOP) and aqueous humour dynamics were investigated in healthy male volunteers. The other eye was treated with vehicle and used as a control. Special attention was also paid to adverse effects. Single and repeated doses were tested. There was a dose related effect on IOP. Significant reductions were observed 4, 8, and 12 hours after application of 1.0, 2.5, or 10 micrograms PGF2 alpha equivalents of the drug. With 10 micrograms the effect lasted 24 hours. An initial tendency towards an increase in IOP was observed for these doses. Repeated doses of 1.0 microgram daily or 0.5 microgram twice daily produced a significant and lasting IOP reduction of about 2 mmHg for 1-2 weeks. Aqueous humour production was not altered, and outflow facility was not significantly changed. There was a dose dependent hyperaemia with a maximum within 2 hours after application. A foreign body sensation, some pain, and photophobia were noted with increasing doses. A slight miosis of 1 mm was seen in three of six eyes treated with 10 micrograms. No signs of intraocular inflammation were recorded, but a slight increase in penetration of fluorescein into the anterior chamber was observed after 16 days of treatment.

Adult↗
PubMed1989

Effects of topically applied PGF2 alpha and its isopropylester on normal and glaucomatous human eyes.

A lipid-soluble PG ester such as PGF2 alpha-IE reduces IOP in the human eye when given in considerably lower doses than are needed for the tromethamine salt of this PG to do so. However, with the pharmaceutical composition now used, the concomitant and dose-related side effects, both objective and subjective, are clearly clinically unacceptable at doses corresponding to the upper part of the dose-response curve for IOP reductions. Moderate side effects were observed after twice-daily treatment with the 0.5 microgram dose for up to two weeks. The pressure reduction obtained in healthy eyes with this dose of PGF2 alpha-IE was less than one would expect with conventional glaucoma drugs. However, the pressure reduction in response to this dose of PGF2 alpha-IE among glaucoma patients who had moderately increased IOP was adequate for clinical use. A useful approach to the development of PGs as potential drugs for the treatment of glaucoma would clearly be the identification of an alternative PG or PG formulation that will permit the use of doses at the upper portion of the IOP dose-response curve without unacceptable side effects. Long-term studies on glaucoma patients, using an appropriate PG formulation, remain to be done before we can evaluate the true clinical usefulness of this new class of ocular hypotensive drugs.

Administration, Topical↗
PubMed1989

Care of pressure sores: a controlled study of the use of a hydrocolloid dressing compared with wet saline gauze compresses.

An occlusive hydrocolloid dressing (Comfeel Ulcus) was compared with a conventional wet saline gauze dressing regarding the effect on ulcer cleansing and healing processes, experience of pain and the consumption of nursing time, in a controlled, randomized and partially single-blind study with parallel groups of long-stay patients with pressure sores. After a few weeks' treatment the relative decrease in ulcer areas with time was larger in the group treated with the hydrocolloid dressing. The difference was almost statistically significant at week 5 (p = 0.054) and definite at week 6 (p = 0.006). At week 6 the median remaining ulcer area in per cent of the initial area was 0% in the hydrocolloid dressing group and 31% in the group treated with saline gauze (p = 0.016). Analysis of the healing distribution function showed the hydrocolloid dressing to be more effective, although the overall difference was non-significant (p = 0.15). Care of the pressure sore took significantly less time with hydrocolloid dressings.

Aged↗
PubMed1987

Secondary aortoenteric fistulas--an analysis of 42 cases.

Secondary aortoenteric fistulas are seen with an increasing frequency which parallels the expansion of reconstructive vascular surgery. During a 12-year period 42 cases have been collected from the hospitals, which perform most of the vascular surgery in Sweden (0.7% of vascular operations). Twenty-five were seen after operation for aortic aneurysm, 15 for aortoiliac occlusive disease, one after renal artery ligation (as a part of reconstruction for renovascular hypertension) and one after operation for an iliac pseudoaneurysm. The frequency of complications during and after the primary operation was high. The interval between operation and onset of fistula symptoms was significantly shorter if there had been infectious complications, the median interval was 32 months, the longest being 10 years. The most important symptom was gastrointestinal haemorrhage, consisting of several small bleeds often combined with septic complications. A large number of negative investigations usually preceded the final diagnosis which was made at exploratory laparotomy. After surgery for the fistula the frequency of complications and mortality, were very high. Mortality was 58%, the most common cause of death being a blow out of the aortic stump. Of those leaving hospital, several further operations were performed with a high mortality. Recurrence of the fistula occurred in 16 out of 34 patients who survived surgery. At follow-up (12-74 months after fistula closure) seven patients were still alive.

Adolescent↗
PubMed1986

Carrier-mediated transport of amino acids through the blood-retinal and the blood-brain barriers.

The uptake-index method was used to study the transport of amino acids through the blood-retinal and blood-brain barriers in rats. The results indicate the existence of at least two different, similar carriers in both barriers, i.e., one each for neutral and basic amino acids. A third separate transport system for taurine was found in the blood-retinal barrier. All of the carrier systems studied transported amino acids from blood to nervous tissue.

Amino Acids↗
PubMed1986

Goniodysgenesis in elderly glaucoma and non-glaucoma patients. A masked slit-lamp and gonioscopy study.

The aim was to elucidate whether goniodysgenesis is more frequently observed in elderly patients with glaucoma, and furthermore, which signs of goniodysgenesis are of importance and most unanimously detected. Thus, 3 examiners evaluated 21 glaucoma patients and 19 non-glaucoma patients in a masked fashion. None of the patients had a first-degree heredity. Gonioscopy, slit-lamp examination and measurements of the corneal and pupillary diameter were performed, in all 26 variables. Significantly (P less than 0.05) more frequent in glaucoma were an increased corneal diameter, scleral overriding, hypoplasia of the pupillary seam, abnormal Schwalbe's line and an opaque pretrabecular membrane (one examiner). Less frequent were a peripupillary yellow pigment ring and pigment stars on the lens. Inter-observer variation was small regarding e.g. corneal diameter but rather large regarding e.g. the pretrabecular membrane.

Aged↗
PubMed1986

Effect of meptazinol on chronic anticoagulant therapy.

Six elderly hospitalized patients (four female, two male; mean age 85.3 years) stabilized on warfarin therapy were treated with meptazinol (200 mg four times daily) for 7 days. There was no significant difference from pretreatment levels either in mean warfarin dosage prothrombin index after introduction or withdrawal of meptazinol. These findings provide no evidence for any major interaction between warfarin and meptazinol.

Aged↗
PubMed1985

Lactate transport through the blood-retinal and the blood-brain barrier in rats.

The retinal and brain uptake index method was utilized in a study on rats to evaluate the existence of transport systems for lactate in the blood-retinal and the blood-brain barrier, respectively. For both retina and brain a saturable, pH-dependent uptake of L-lactate was observed. The uptake could also be inhibited by pyruvate and 3-hydroxybutyrate. It is concluded that lactate is transported through the blood-retinal and the blood-brain barriers by similar carrier-mediated transport systems with affinity also to other monocarboxylic acids, such as pyruvate, and to the ketone body 3-hydroxybutyrate. The pH-dependence of the lactate transport suggests that co-transport of H+ ions or counter-transport of OH- ions takes place.

3-Hydroxybutyric Acid↗
PubMed1984

Blood-ocular and blood-brain barrier function in streptozocin-induced diabetes in rats.

Edetic acid labeled with chromium 51 was injected intravenously in normal rats and in rats with streptozocin-induced diabetes. One hour after the injection the animals were killed and the concentrations of edetic acid 51Cr in vitreous body, retina, and brain were determined. No significant difference was observed between the two groups for either tissue. In a second series, a mixture of tritiated 1-glucose and aminohippuric acid tagged with carbon 14 was injected instead of edetic acid. A substantial accumulation of aminohippuric acid 14C compared with tritiated 1-glucose was observed in the vitreous body and the brain of diabetic rats in comparison with the control group. It is concluded that untreated streptozocin-induced diabetes in rats for one to two weeks will not cause a generalized increase in the permeability of the blood-ocular or the blood-brain barriers, but organic acids may accumulate in the vitreous body as well as in the brain as a consequence of reduced outward transport through these barriers.

Aminohippuric Acids↗
PubMed1984

Choline transport through the blood-retinal and the blood-brain barrier in vivo.

The uptake index method was used to study retinal and cerebral uptake of [14H]labelled choline in rats. In both tissues a saturable uptake was observed. This uptake was significantly inhibited by 10-20 mM unlabelled choline chloride as well as by 10 mM hemicholinium-3. It is concluded that choline passes the blood-retinal barrier by a carrier-mediated transport system similar to that in the blood-brain barrier.

Animals↗
PubMed1983

What causes the failures in surgically constructed arteriovenous fistulas?

A retrospective analysis was made of 191 uraemic patients whose first arteriovenous fistula was constructed in the period 1972-1978. Only direct-type lower forearm fistulas were considered. The aim was to identify and evaluate factors influencing fistula patency rate. Evaluation was done by simple and multiple regression analyses and by actuarial life table computation. Early failure of fistula occurred most frequently in patients with diabetes, peroperative blood pressure less than 110 mmHg, small-calibre veins and/or less than maximal uraemia. The early failure rate among patients with low peroperative blood pressure was 53%, and in the other patients 24%. Among patients with serum creatinine higher than 1 140 mumol/l the corresponding figure was 11%, while in those with lower values it was 35%. Long-term fistula patency was influenced by sex (with advantage to males), by diabetes or diabetic vasculopathy, and seemingly be a tendency to hypotension in some patients. Direct-type forearm fistula may well be utilized in patients with narrow veins. The operation should not be performed long before induction of haemodialysis. This is because some of the fistula's lifespan will be wasted if it is created too soon, and because the early failure rate is lower in patients with advanced uraemia. The analysis also reflects problems that can be anticipated, as diabetics constitute an increasing proportion of patients requiring vascular access.

Adolescent↗
PubMed1983

Adjuvant intravenous sympathetic block with guanethidine in construction of arteriovenous fistulas for blood access.

A prospective randomized investigation of regional intravenous sympathetic block with guanethidine (RGB) was made in patients undergoing surgical construction of arteriovenous fistula (AVF) for vascular access. The blockade was preoperatively performed on chronically uraemic patients without previous vascular access surgery. The studied data were preoperative forearm blood flow, intraoperative fistula blood flow and flow resistance, and patency rates of AVF. Serial occlusion plethysmography showed a 152% increase in mean forearm blood flow in the RGB group, with significant (p less than 0.001) difference from the controls. The fistula blood flow resistance was decreased (p less than 0.05). The early failure rate was 1/17 among the patients treated with RGB and 3/17 in an otherwise comparable control group. RGB may be useful for reducing early failure rates after construction of AVF, by facilitating blood flow through the fistula.

Adolescent↗
PubMed1982

Monitoring acetazolamide treatment.

Electron capture gas chromatography was used to determine plasma concentrations after various doses of acetazolamide. In 40 patients steady state plasma concentrations were determined for daily doses of 187.5, 375, 750, and 1000 mg. Mean plasma concentrations increased with increasing dosages but there were marked interindividual variations. Part of the interindividual variation was explained by a positive correlation between age and plasma concentration. In 10 patients with previously untreated glaucoma intraocular pressure (IOP) responses and plasma concentrations were determined for increasing doses of acetazolamide. Increasing IOP reductions were obtained up to a dose of 750 mg while a daily dose of 1000 mg acetazolamide had no further effect on IOP. The relationship between IOP reduction and plasma concentration showed great interindividual variations, from a pressure reduction of 11 mmHg at 6 micrograms/ml acetazolamide to a pressure reduction of 0 mmHg at 11 micrograms/ml. As a rule, the maximal effect on IOP was obtained at a plasma concentration between 5 and 10 micrograms/ml. In most patients a daily dose of 1000 mg resulted in plasma concentrations above 10 micrograms/ml.

Acetazolamide↗
PubMed1981

Results from 88 consecutive prophylactic carotid endarterectomies in cerebral infarction and transitory ischemic attacks.

Thirty-two patients with transitory ischemic attacks (TIA), 55 with cerebral infarction (minor stroke) and one with a disturbing bruise underwent carotid endarterectomy during a 4 year period. Within the first 2 weeks postoperatively, 10 patients (11%) had developed new neurological symptoms from the operated side. Two patients died postoperatively due to major stroke and 2 patients developed persistent neurological deficits, yielding a total operative mortality and permanent morbidity rate of 4.5%. In the other 6 patients, the neurological signs and symptoms disappeared completely within one month. During a follow-up for an average of 21 months, the only symptoms from the operated side were TIA in 2 patients, while 3 patients developed TIA and 5 infarctions from other vascular territories.

Age Factors↗
PubMed1981

The uptake index method applied to studies on the blood-retinal barrier. I. A methodological study.

The validity of the uptake index method for studies on passage through the blood-retinal barrier was evaluated. Data for the brain were also obtained for comparison. A rapid intracarotid injection of 0.2 ml buffered Ringer solution in rats did not result in a measurable increase in the permeability to EDTA for either the blood-retinal or the blood-brain barriers, while a markedly hypertonic solution caused an immediate osmotic breakdown of both barriers. For determinations of the retinal uptake index (RUI) 3HOH was found to be a suitable reference substance. A more diffusible reference, such as 14C-ethanol, resulted in a lower net extraction, probably due to a more rapid wash-out by the choroidal blood flow. Clearance of both reference and test substances from the retina was considerably faster than from the brain. For this reason a 5-s interval between the intracarotid injection and the enucleation was used as routine for determinations of RUI. With this technique RUI for the transported monosaccharide 3-O-methyl-D-glucose was significantly larger than for L-glucose, 53.8 and 14.2% respectively. The RUI for L-glucose was mainly due to L-glucose confined to extravascular choroidal fluid adhering to the retinal tissue samples. By prolonging the interval between injection and enucleation, and subtracting the activity due to recirculation, this extraretinal contamination could be practically eliminated. It is concluded that the uptake index method can be a useful tool in studies on transport of metabolic substrates through the blood-retinal barrier.

3-O-Methylglucose↗
PubMed1981

The uptake index method applied to studies on the blood-retinal barrier. II. Transport of several hexoses by a common carrier.

The uptake index method was used for studies on the passage of various monosaccharides across the blood-retinal and the blood-brain barriers in albino rats. The results indicate large similarities for the hexose transport through the two barriers. Thus a stereo-specific, saturable transport of glucose was observed for both barriers. The carriers involved showed measurable affinity for 2-deoxy-D-glucose, 3-0-methyl-D-glucose, D-mannose and D-galactose, but not for L-glucose, D-fructose or D-ribose. The relative affinities of the various hexoses to the carriers were similar. Phloretin and phloridzin both reduced retinal and brain uptake of D-glucose.

Animals↗