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Biomedical subjects

A Himmelmann

Publications and source records attributed to A Himmelmann.

At least 73 records · Page 4Linked to original sources
PubMed1994

Predictors of blood pressure and left ventricular mass in the young: the Hypertension in Pregnancy Offspring Study.

The present study evaluates potential predictors for the future blood pressure and left ventricular mass in children. Fifty-two children were studied at mean age 12.6 +/- 1.5 years and reexamined after 5.6 years. Thirty-six children were born to mothers who had hypertension during pregnancy and 16 children were born after normotensive pregnancies by mothers who remained normotensive at follow-up. Blood pressure was measured at rest and during physical exercise. Left ventricular mass was calculated from M-mode echocardiography, and erythrocyte sodium and potassium concentrations were determined. A stepwise multiple linear regression analysis was used to predict subsequent blood pressure and left ventricular mass. Final systolic blood pressure was best explained by initial systolic blood pressure, erythrocyte potassium concentration, gender, and erythrocyte sodium concentration. Final diastolic blood pressure was best explained by erythrocyte potassium concentration. Gender and initial left ventricular mass were predictors of left ventricular mass at follow-up. This prospective study corroborates previous findings that blood pressure measured in children predicts their future blood pressure. Furthermore, an independent inverse relationship between childhood erythrocyte potassium concentration and adolescent blood pressure is demonstrated. Male gender and an early increased left ventricular mass are independent predictors of an increased left ventricular mass in adolescents.

Blood Pressure↗
PubMed1994

Relation of maternal blood pressure during pregnancy to birth weight and blood pressure in children. The Hypertension in Pregnancy Offspring Study.

OBJECTIVE: To evaluate the importance of perinatal factors, e.g. low birth weight, reduced gestational period and elevated maternal blood pressure during pregnancy, as well as high maternal blood pressure at follow-up 7-12 years after pregnancy, on blood pressure in children born after normotensive and hypertensive pregnancies. DESIGN: Follow-up study in children from hypertensive pregnancies and a control group of children born after normotensive pregnancies. SETTING: University Hospital, Göteborg, Sweden. SUBJECTS: Thirty-six children born after hypertensive pregnancies and a control group of 17 children born after normotensive pregnancies were studied at a mean age of 12.5 years. MAIN OUTCOME MEASURE: Blood pressure. RESULTS: Systolic blood pressure was higher in children born after hypertensive pregnancies. They also had lower birth weight and a shorter gestational period. There was a negative correlation between the highest recorded maternal blood pressure during pregnancy and birth weight of the child and a positive correlation between maternal blood pressure and blood pressure in their offspring. No correlation was found between birth weight and blood pressure in these children. CONCLUSIONS: Children born after hypertensive pregnancies have higher blood pressure compared to children born after normotensive pregnancies. There is a positive relationship between childhood blood pressure and maternal blood pressure during pregnancy.

Adolescent↗
PubMed1994

Blood pressure and left ventricular mass in children and adolescents: the Hypertension in Pregnancy Offspring Study.

The etiology of essential hypertension is still a matter of some speculation. Research concerned with pre-hypertensive mechanisms of human essential hypertension usually includes subjects with either borderline hypertension or with a positive family history of hypertension. High blood pressure and increased left ventricular mass are risk factors for cardiovascular disease in adults. Much information about hypertension and other coronary artery disease risk factors in children and adolescents has been collected in the past two decades, and during the last years new evidence has emerged which indicates that essential hypertension originates early in life. Several studies have suggested that children and adolescents born following hypertensive pregnancies may constitute a risk group for future hypertension. The present study addresses the question concerning the future cardiovascular risk in offspring of women who had hypertension during pregnancy. The subjects in the present study were also studied in the search for early pre-hypertensive mechanisms. Fifty-nine children were studied, their mean age being 12.6 years. Forty-two children were born to mothers who had hypertension during pregnancy and 17 children were born after normotensive pregnancies by mothers who remained normotensive at follow-up 7-12 years after pregnancy. Blood pressure was measured at rest and during physical exercise. Left ventricular mass was calculated from M-mode echocardiogram. Erythrocyte concentrations of sodium and potassium and Na-K-ATPase activity were determined. Perinatal and maternal characteristics were collected from hospital records for all deliveries. Twenty-nine males and 23 females, of the initially studied children, were reexamined after 5.6 years. The present study demonstrates that children whose mothers had hypertension during pregnancy and were hypertensive at follow-up had higher blood pressure than children born following normotensive pregnancies. A familial factor for hypertension was an independent determinant of blood pressure, but not a determinant of left ventricular mass. Children born following hypertensive pregnancies had lower birth weight, shorter gestational period and higher blood pressure at follow-up. There was no relationship between birth weight and blood pressure in these children, but there were associations between maternal blood pressure during pregnancy and birth weight as well as blood pressure at follow-up. The difference in blood pressure persisted as the children matured. Particularly the children whose mothers had hypertension during pregnancy and were hypertensive at follow-up maintained their rank with regard to blood pressure and left ventricular mass during adolescence.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗
PubMed1994

Influence of sex on blood pressure and left ventricular mass in adolescents: the Hypertension in Pregnancy Offspring Study.

The aim of the present longitudinal study was to describe determinants of blood pressure (BP) and echocardiographically calculated left ventricular mass in adolescents with a variable risk of future hypertension. BP was measured and M-mode echocardiography was performed in 52 children, 29 male and 23 female, at a mean age of 12.6 +/- 1.5 years. A re-examination was performed after 5.6 years. Thirty-six children were born to mothers who had hypertension during pregnancy whereas 16 children were born after a normotensive pregnancy. During follow-up a difference in body weight (P < 0.01) and height (P < 0.001) developed between male and female subjects. At the same time a difference in systolic blood pressure (SBP) appeared between sexes (P < 0.01). At follow-up there were significant correlations between sex and SBP (r = 0.37, P < 0.01) and left ventricular mass (r = 0.54, P < 0.001). In multivariate analyses sex emerged as a factor explaining the variance of both SBP and left ventricular mass at follow-up. In conclusion a difference in BP between male and female subjects emerges concomitantly with differences in body size during adolescence. An independent influence of sex on both BP and left ventricular mass appears in parallel with this.

Adolescent↗
PubMed1994

Preoperative diagnosis of Meckel's diverticulum by pertechnetate scan and laparoscopic resection.

Acute lower gastrointestinal hemorrhage in a 17-year-old boy was caused by a Meckel's diverticulum 1 day after ingestion of 500 mg acetylsalicylic acid. After conservative treatment of the bleeding, the diverticulum was diagnosed in the free interval by technetium pertechnetate scintigraphy, which showed an accumulation in the right lower quadrant simultaneously with the accumulation in the gastric mucosa. Elective explorative laparoscopy confirmed the diverticulum, and the resection was performed by laparoscopic means. Histology showed gastric-type mucosa in the diverticulum. The treatment of choice for Meckel's diverticulum, when it is diagnosed preoperatively or during laparoscopy, is laparoscopic resection.

Adolescent↗
PubMed1994

Five-year follow-up of blood pressure and left ventricular mass in children with different maternal histories of hypertension: the Hypertension in Pregnancy Offspring Study.

OBJECTIVE: To follow the changes in blood pressure and echocardiographically determined left ventricular mass in offspring of mothers who had hypertension during pregnancy. DESIGN: Longitudinal study with a 5-year follow-up. METHODS: Nineteen offspring of mothers who had hypertension during pregnancy, and sustained hypertension at follow-up 7-12 years after term, were examined, by blood pressure measurement and M-mode echocardiography, at a mean age of 12.8 years (range 10.6-16.4) and were re-examined 5.6 years later. For comparison, 17 children born to mothers who had hypertension during pregnancy, but were normotensive at follow-up, were also examined. A control group of children born following a normotensive pregnancy was also recruited. Comparisons were made by analysis of variance among the three groups. RESULTS: At the initial examination systolic blood pressure was significantly higher in the children born to mothers who had hypertension during pregnancy and were hypertensive at follow-up. This difference persisted in the adolescents at follow-up. No differences among the three groups in echocardiographically determined left ventricular mass were seen, either at the initial examination or at follow-up. There was a significant correlation between left ventricular masses determined 5 years apart (r = 0.53, P < 0.001). CONCLUSIONS: The present longitudinal study demonstrates that offspring of mothers with hypertension during pregnancy, that was sustained at follow-up, have higher blood pressure than controls. Children with different maternal histories of hypertension maintain their rank with regard to left ventricular mass during adolescence.

Adolescent↗
PubMed1993

[Development of dementia].

A 67-year old male patient was admitted to our clinic because of slowly developing dementia. Severe dysfunction of memory, confusional states and urinary incontinence were observed. A diagnosis of general paresis was made by positive serology for syphilis and CSF examination. The patient's condition improved markedly after high-dose penicillin G treatment.

Aged↗
PubMed1993

Efficacy and tolerability of tropisetron and dexamethasone in the control of nausea and vomiting induced by cisplatin.

A multicentre study was performed at four oncology centres in Sweden, in 160 chemotherapy-naive women, primarily with ovarian or endometrial carcinomas. Abdominal surgery preceded chemotherapy in 146 (91%) women, and another 39 (24%) women had a history of radiotherapy. The chemotherapy regimens contained cisplatin (50-100 mg/m2), in combination with a variety of other agents. In Course 1, all patients received tropisetron (5 mg i.v. Day 1; 5 mg p.o. Days 2-6) and 84% of patients achieved total or partial control of vomiting; 95% of patients achieved total or partial control of nausea during the first 24 hours. Vomiting was least successfully controlled on Day 2 (73% total or partial control) and Days 2-4 for the control of nausea (81, 83, 88% total or partial control, respectively). Patients with partial response in Course 1 (39% of patients) were randomized to addition of dexamethasone or placebo in Course 2. In Course 2, tropisetron plus dexamethasone (Group B2) prevented acute vomiting in 75% of patients, compared with 40% of patients receiving tropisetron plus placebo (Group B1). Over the entire 6 days, there was no vomiting at all in 54% and 20% of B2 and B1 patients, respectively. In Course 2, acute nausea was prevented in 75% of patients (receiving B1) and in 37% of patients (receiving B2). For nausea, over the complete 6 days, the figures were 64% and 3% (p < 0.001). This indicated that patients with incomplete control of emesis in Course 1 benefited from the addition of dexamethasone, provided that it was added for each of the 6 days studied.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

Blood pressure and left ventricular mass in children with different maternal histories of hypertension: the Hypertension in Pregnancy Offspring Study.

OBJECTIVE: To study blood pressure and echocardiographically determined left ventricular mass in children born to mothers who had been hypertensive during the pregnancy and to assess the influence of a maternal factor for hypertension on blood pressure and left ventricular mass. METHODS: Blood pressure was measured and M-mode echocardiography was performed in 42 children (aged 10.6-16.4 years) born to mothers who had been hypertensive during the pregnancy. For comparison, a control group of 17 children born after a normotensive pregnancy was used. RESULTS: Children born to mothers who had had a hypertensive pregnancy and who showed sustained hypertension during a follow-up, had higher systolic (P < 0.001) and diastolic (P < 0.05) blood pressure. No differences in left ventricular mass were seen. There was a significant correlation between left ventricular mass and systolic blood pressure (r = 0.40; P < 0.01). In multivariate analyses both systolic and diastolic blood pressure were independently related to a familial factor for hypertension, whereas left ventricular mass was not related to a familial factor for hypertension. CONCLUSIONS: Children born after a hypertensive pregnancy have higher blood pressure than children born after a normotensive pregnancy. A familial factor for hypertension was correlated with blood pressure, but not left ventricular mass in the children studied.

Adolescent↗
PubMed1992

Human small cell lung cancer expresses the octamer DNA-binding and nervous system-specific transcription factor N-Oct 3 (brain-2).

Small cell lung cancer (SCLC) cells express several characteristics of neuronal cells, including synthesis of neuropeptides and expression of the respective receptors. Establishment and maintenance of the neuronal phenotype of SCLC may depend on expression of gene transcription factors inherent to the central nervous system. The present study shows the nervous system-specific transcription factor N-Oct 3 (brain-2) to be expressed in all 13 SCLC cell lines investigated. Furthermore, N-Oct 3 (brain-2) was also found in SCLC-derived skin metastasis. In contrast, in extracts and RNA of non-SCLC cell lines and non-SCLC tumor tissues, such as lung squamous, large cell, and adenocarcinoma, expression of N-Oct 3 (brain-2) was not detectable. These data support the concept that SCLC cells derive from the neuroectodermal cell lineage since expression of N-Oct 3 (brain-2) protein is highly abundant at the neural tube stage and in the adult restricted to the neuroectodermal cell lineage.

Carcinoma, Small Cell↗
PubMed1992

Chromosome aberrations in 35 primary ovarian carcinomas.

Cytogenetic analysis was performed on short-term cultures of primary ovarian carcinomas from 62 patients. Cytogenetic analysis was successful in 59 cases. Clonal chromosome aberrations were detected in 35 tumors. Only numerical changes or a single structural change were found in five carcinomas: trisomy 12 was the sole anomaly in two tumors, one tumor had the karyotype 50,XX, + 5, + 7, + 12, + 14, a fourth tumor had a balanced t(1;5), and the fifth tumor had an unbalanced t(8;15). The fact that four of these five carcinomas were well differentiated suggests that simple karyotypic changes are generally characteristic of these less aggressive ovarian tumors. The majority of the cytogenetically abnormal tumors (n = 30) had complex karyotypes, with both numerical and structural aberrations and often hypodiploid or near-triploid stemlines. The numerical imbalances (comparison with the nearest euploid number) were mostly losses, in order of decreasing frequency -17, -22, -13, -8, -X, and -14. The structural aberrations were mostly deletions and unbalanced translocations. Recurrent loss of genetic material affected chromosome arms 1p, 3p, 6q, and 11p. The breakpoints of the clonal structural abnormalities clustered to several chromosome bands and segments: 19p13, 11p13-15, 1q21-23, 1p36, 19q13, 3p12-13, and 6q21-23. The most consistent change (16 tumors) was a 19p + marker, and in 12 of the tumors the 19p + markers looked alike.

Adult↗
PubMed1992

Hexamethylmelamine as second-line therapy in platin-resistant ovarian cancer.

A total of 61 patients with recurrent or persistent clinically measurable platin-resistant epithelial ovarian carcinoma were treated with 260 mg/m2 oral hexamethylmelamine daily for 14 days, repeated at 4-week intervals. Platin resistance was defined as progression or stable disease during cis- or carboplatin treatment (used alone or in combination with other drugs), or relapse within 6 months after the end of that therapy. Fifty patients were evaluable for response and 57 for toxicity. The objective response rate was 14% (3 complete and 4 partial responses). The response rate was higher in patients with relapse within 6 months than in patients with progression or stable disease on platin-based therapy. This observation underscores the importance of defining response and time to progression after first-line chemotherapy. The median duration of response was 8 months and the median survival in responding patients was 9+ months versus 5 months for patients with progression on hexamethylmelamine. Nausea and vomiting requiring antiemetic treatment occurred in 8 (14%) patients and reversible peripheral neuropathy in 3 patients. Two patients developed agitation, insomnia, and depression during hexamethylmelamine therapy. In conclusion, the 14% objective response rate and the occurrence of complete responses with oral hexamethylmelamine treatment in a group of ovarian cancer patients with true platin resistance are noteworthy.

Adult↗
PubMed1992

Prospective histopathologic malignancy grading to indicate the degree of postoperative treatment in early cervical carcinomas.

During a 9-year period, 92 women with squamous cell carcinoma of the cervix, FIGO stages IA1-IIA, were subjected to primary surgery according to Wertheim Meigs. Grading according to a malignancy grading score (MGS) and evaluation of tumor size before surgery together with surgical findings of positive nodes or insufficient surgical margin at the primary site were used to identify persons prospectively at high risk for relapse. Twenty-five women thus received postoperative treatment. Results among node-positive patients were good; only 2 out of 12 patients relapsed. Among 67 node-negative patients in stages IA2-IIA, 4 relapses occurred. These 4 patients had greater than or equal to 16 risk points according to MGS, but small tumors. Instead of tumor size, supplementary risk factor is therefore needed. Among the few patients in stage IA1, no high-point patients relapsed. These patients would probably have done just as well with less-extensive surgery.

Adult↗
PubMed1992

Prognostic impact of chromosome aberrations in ovarian cancer.

Clinico-cytogenetic correlations were assessed in 88 patients with malignant ovarian tumours. Cytogenetic analysis of the primary tumours yielded normal karyotype (N) in 33 patients and abnormal karyotypes (A) in 55 patients. Within the A group, seven tumours had simple abnormalities (AS), i.e., numerical changes only or a single structural aberration, and 48 had karyotypes with complex aberrations (AC). A correlation analysis between groups N and A revealed that cytogenetic abnormalities were more often found among seropapillary tumours, and that cases with abnormal karyotypes on average were of higher stage and more often had residual tumour mass after initial surgery (P less than 0.05 for all variables). When the three groups N, AS, and AC were compared, they were found to be significantly different with regard not only to the three parameters mentioned above, but now tumour grade also appeared to correlate with karyotypic pattern (P = 0.001), with poorly differentiated tumours having the most complex karyotypes. In a correlation analysis between karyotypic pattern and survival, group A patients had shorter survival than group N (P = 0.049). In the corresponding analysis between groups N, AS, and AC, the differences were also significant (P = 0.039), with shorter survival in group AC than in groups N and AS. Stage, grade, residual tumour after primary surgery, and performance status also correlated with survival time. A multivariate analysis identified abnormal karyotype as being independently associated with short survival in advanced clinical stages (P = 0.030) of ovarian carcinoma. We conclude that cytogenetic analysis of tumour cells may be of clinical value in the assessment of prognosis in patients with malignant ovarian tumours.

Adult↗
PubMed1991

Calcium antagonists in antihypertensive combination therapy.

Calcium antagonists can be used with a number of other antihypertensive compounds. The combined use of a dihydropyridine calcium antagonist and beta-blocker is well established and is probably the most efficacious combination for routine use. Angiotensin-converting enzyme (ACE) inhibitors may also constitute a suitable addition to calcium antagonist therapy, whereas little benefit appears to be derived from the combined use of a calcium antagonist and a diuretic. Other compounds, e.g., alpha-adrenoceptor blockers, can also be given together with calcium antagonists, although this should be done with great caution because dramatic reductions in blood pressure may result. It is worth noting that in addition to the improved antihypertensive efficacy produced by some of the calcium antagonist combinations, potentially positive metabolic changes may also occur, e.g., a reduction in serum cholesterol, when a calcium antagonist and a beta-blocker are combined.

Angiotensin-Converting Enzyme Inhibitors↗