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Biomedical subjects

A Carstensen

Publications and source records attributed to A Carstensen.

7 recordsLinked to original sources

Muscle protein synthesis is impaired in nephrotic rats.

Muscle protein synthesis is impaired in nephrotic rats: muscle and hepatic protein synthesis was measured as the incorporation of [3H]phenylalanine [3H]phe) into muscle and liver in male Sprague-Dawley rats with passive Heymann nephritis (HN) in comparison to both normal male (SDM) and female Sprague-Dawley rats (SDF). Incorporation of [3H]phe was significantly less muscle in HN (1.55 +/- 0.08 x 10(4) cpm/g muscle/h) than in SDM (2.55 +/- 0.14 x 10(4), p < 0.01) and no different than in SDF (1.64 +/- 0.23 x 10(4)). Growth rate was also significantly less in SDF and HN compared to SDM. Total [3H]phe incorporation and the % of [3H]phe incorporated into muscle correlated inversely with urinary albumin excretion in HN (p < 0.01) but not with serum albumin. In contrast, [3H]phe incorporation was increased in livers of HN (13.89 +/- 0.99 x 10(3) cpm/g rat/h) compared to either SDM (5.96 +/- 0.38 x 10(3), p < 0.01) or SDF (4.71 +/- 0.35 x 10(3), p < 0.01). Total liver mass, liver protein content, and the ratio of liver weight/body weight were all increased in HN. There were no differences in liver weight, liver protein content, or the ratio of liver weight/body weight between SDM and SDF. We have previously shown that decreased muscle protein accrual in HN cannot be overcome by increasing dietary protein intake. Hepatic protein synthesis and mass are increased in proteinuric rats while muscle protein synthesis is reduced. As a consequence growth rate and muscle protein accrual are diminished in nephrosis. The mechanism responsible for reduced muscle protein synthesis in the nephrotic syndrome is unknown.

Animals

Multivariable optimization of mechanical ventilation. A linear programming approach.

The proposed method aims at improved ventilatory care with reduced morbidity. It combines two important aspects of mechanical ventilation: gas exchange and lung mechanics. A single criterion was selected as optimization index of lung trauma: peak respiratory power (PRP) defined as the maximum product of pressure times flow during inspiration. Arterial blood gases reflect gas exchange and constitute the constraints of the problem. The constraints as well as the optimization index are expressed as linear functions of the input variables (frequency of breathing, tidal volume, and positive end expiratory pressure). A linear programming approach can therefore be used to determine the values of input variables that minimize PRP and at the same time keep arterial blood gases within the prescribed limits. The coefficients of the constraints and the optimization index equation are found by manipulating input variables in order to obtain four different values of PaO2, PaCO2 and PRP (there are four coefficients in each equation). The coefficients can then be calculated and the optimization procedure run. In a pilot study 5 patients suffering from diseases of varying pulmonary pathology were investigated with this method. In 4 out of 5 the ventilator treatment improved in terms of blood gas values (mean increase in PaO2 was 4.7%) and reduction of mechanical load on the lungs (mean PRP reduction was 20%). Lower PRP is accompanied by lower mean power and pressure values, which results in increased cardiac output. Presently, the main problem is the time it takes to determine the patient coefficients (approx one hour), a procedure that needs to be simplified.

Acute Disease

[Immunomodulation by cryosurgery in malignant melanoma].

Cryosurgery is a well-known, established method for the local destruction of tumor tissue by freezing. The assumption that, in addition to a physical and blood vascular phase, an immunological phase exists, has been discussed by many authors and tested using animal models. These results can only be transferred to humans in a limited sense. During the last year, we initiated a randomized study "Cryosurgery versus Conventional Surgery", whereby the peripheral blood and the normal skin from the areas surrounding the resection were compared. We were able to demonstrate in the peripheral blood of 8 cryosurgery patients a postoperative increase in the total and helper T-cells, HLA-DR-positive cells, and the ratio helper/suppressor T-cells in comparison to preoperative values. In the 8 patients treated with conventional surgery, these parameters decreased slightly or remained the same. The differences were highly significant (p = 0.001) to significant (p = 0.01). The results from the first 16 are patients studied presented and discussed here.

Adult

Fluorescence-activated cell analysis of P-fimbriae receptor accessibility on uroepithelial cells of patients with renal scarring.

Pyelonephritogenic Escherichia coli possess P-fimbriae that bind to uroepithelial cells by recognizing a receptor containing the alpha-D-Galp-(1-4)-beta-D-Galp carbohydrate structure. The accessibility of P-fimbriae receptors was determined using uroepithelial cells from 19 female patients with verified renal scarring and a history of febrile urinary tract infection, and 13 healthy controls. The binding of fluorescein isothiocyanate labeled P-fimbriated Escherichia coli to a large number of uroepithelial cells from each individual was studied using the method of fluorescence-activated cell sorting analysis, which allows examination of a large number of cells and selection of cells of a given size. The uroepithelial cells from the patients exhibited a significantly higher binding capacity to P-fimbriated Escherichia coli than did uroepithelial cells from healthy controls (p less than 0.01). The determination of P-fimbriae receptor accessibility on uroepithelial cells may be useful for detecting risk groups among patients with recurrent urinary tract infections.

Adult