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Biomedical subjects

A Kallner

Publications and source records attributed to A Kallner.

At least 91 records · Page 5Linked to original sources
PubMed1988

On reference values for tumor markers in prostatic carcinoma.

Serum contents of prostatic acid phosphatase, neopterin, osteocalcin, tissue polypeptide antigen and CA-50 were measured before onset of treatment in 83 patients suffering from prostatic carcinoma. In an attempt to identify patients with poor prognosis the data were related to patient survival after 2 years. It was found that the standard cut off values, obtained from the upper limits of normal, healthy subjects, were sensitive but had low specificity. A better relation to prognosis was usually found at a higher discrimination limit. The degree of elevation appears more important than the elevation of the markers as such in indicating a poor prognosis. By systematic adjustment of the discrimination levels, higher specificity can be obtained with little loss of sensitivity.

Acid Phosphatase↗
PubMed1987

Release characteristics of enzymes used in the diagnosis of myocardial infarction.

Release characteristics of S-LD, S-LD1, S-ASAT, S-CK and S-CK-MB were studied in 47 consecutive AMI patients. In addition, previously obtained data for serum myoglobin (S-MYO) were compared. Serum was sampled at regular intervals after admission to the Coronary Care Unit (CCU). The release rate and half lives of the enzymes were calculated according to a one-compartment kinetic model. The time to peak values, the time of total release and the half lives were interrelated in the following order: MYO less than CK-MB less than CK less than ASAT less than LD1 less than LD which coincides with the wellknown appearance and disappearance rates in serum. The ratio between mean peak values and upper reference limits followed the reverse order. The finding that the release rate of enzymes and half-lives co-vary is hypothetically suggested to be attributed to differences in rate of membrane diffusion. There is indirect evidence that a slow indicator such as LD1 reflects infarct size better than fast indicators with rapid release and removal such as MYO or CK-MB. However, these fast markers have a better signal to noise ratio, whereby they probably reflect changes in the infarction process better.

Aged↗
PubMed1987

Highly sensitive assays of serum-thyrotropin in the diagnosis of hyperthyroidism: assessment of performance and reference values.

The performance of three different highly sensitive immuno-assays for thyrotropin in serum (S-TSH) was compared. Specimens from 803 patients with suspected hyperthroidism or other thyroid disease were used. Hyperthyroid patients were identified and characterized by determining serum thyroid hormones and by clinical observation. The performance of the methods in discriminating between hyperthyroidism and euthyroidism was described in terms of diagnostic sensitivity and specificity. The performance was also assessed by systematically varying the reference values. If patients with treated hyperthroidism were eliminated, the three S-TSH assays performed equally well at a suggested lower reference value of 0.4 mU/l. A diagnostic efficiency of more than 0.95 was achieved at the observed prevalence of disease (0.12). A graphical model which allows an adjustment of reference values to favour sensitivity or specificity is presented. Reference values were also calculated from the euthyroid subjects using parametric and non-parametric approaches. The specificity, when using the recommended discrimination level, suggests that patients with low S-TSH values should be subjected to further investigation by biochemical or other methods.

Adolescent↗
PubMed1986

Evaluation of rapid methods for the detection of bacteriuria (screening) in primary health care.

The diagnostic performance of six methods for bacteriuria testing has been studied in 781 urine specimens obtained in primary health care, using conventional culture as reference method. The cut-off limits for classification of test results into positive and negative have been optimized with respect to diagnostic performance in primary health care. With optimized tests the following diagnostic efficiencies were obtained: Bacterial ATP, 0.94; Bacterial count in sediment, 0.93; Nitrite test, 0.92; Dipslide test, 0.92; White cell count in sediment; 0.87; Goffulocyte esterase test; 0.83. The diagnostic performance was also studied for all combinations of two tests. The highest diagnostic efficiency (0.96) was obtained by combining the ATP and dipslide tests. High diagnostic efficiencies can be obtained by a rapid primary test, using other tests for follow-up testing of specimens with intermediate or uninterpretable primary results. The most promising results were obtained by using ATP as the primary test, with follow-up testing of specimens with 3-25 nmol/l of ATP (12 per cent of the specimens). Follow-up testing by conventional culture resulted in overall diagnostic efficiency of 0.98. By performing the nitrite test on specimens with intermediary ATP-results, 81 per cent of the patients with UTI can be classified without culture. Only patients with intermediary ATP and negative nitrite results (10 per cent of the total number) will have to wait for final diagnosis based on conventional culture. Some alternative strategies to combine available methods are discussed in detail. Major advantages of the ATP test are that the test can be performed while the patients are waiting; it provides a numerical and objective result, and, in contrast to culture, it is not influenced by adhesion of bacteria to somatic cells.

Adenosine Triphosphate↗
PubMed1985

Release patterns of CK-MB and mitochondrial CK following myocardial ischaemia.

Following myocardial damage as in acute myocardial infarction (AMI) or open heart surgery, the tissue damage might result in a release of mitochondrial CK (CK-MIT). The presence of this CK isoenzyme in serum may be detected after chromatographic separation of CK-activity on Sephacryl S-200. By combining chromatographic separation of CK-MB with immunologic inhibition of CK-M, both CK-MB and CK-MIT can be estimated in serum. Using this procedure changes in enzyme activities were studied in ten patients with AMI and twelve patients subjected to open heart surgery using cardioplegia. Following AMI CK-MB peaked about 24 h after onset of ischaemic symptoms. CK-MIT increased similarly and reached a plateau after 24 h where it remained during an additional 24-36 h. At peak CK-MB concentration, the corresponding CK-MIT activity was about 22% of the CK-MB activity. Following cardiac surgery there was a rapid release of CK-MB with a peak about 5 h after release of aortic cross-clamping, and with a simultaneous CK-MIT activity amounting to 19% of the CK-MB activity. In conclusion, CK-MIT is released into serum following myocardial ischaemia. Its appearance has time characteristics similar to that of other mitochondrial enzymes. The CK-B method does not specifically determine CK-B, but non-CK-M, which in cardiac ischaemia at peak serum CK-MB concentrations includes about 20% CK-MIT.

Adult↗
PubMed1985

Formation of carbon dioxide from ascorbate in man.

Volunteers were given a steady intake of various individually different daily dosages of ascorbic acid. After 3 weeks 1-14C-labelled ascorbate was given together with various amounts of unlabelled ascorbic acid (90-1000 mg). Regardless of the total daily dose in cases where the carrier dose amounted to 180 mg or more, carbon dioxide was recovered from the breath. The amount recovered ranged from 1 to more than 30% of the given dose. The larger the amount of carrier the larger was the amount of label recovered as carbon dioxide. It is suggested that the formation of carbon dioxide is due to a presystemic effect as a result of microbiological or chemical degradation of ascorbate in the intestine.

Ascorbic Acid↗
PubMed1985

Psychosocial and physiological factors in relation to blood pressure at rest--a study of Swedish men in their upper twenties.

The interrelationships between psychosocial factors, several physiological variables and blood pressure (BP) were investigated in 88 young men (aged 26-32 years) in whom high, intermediate or low BP had been recorded at the age of 18 years. In the original high BP group, venous plasma noradrenaline was normal but adrenaline levels elevated. At the follow-up adrenaline correlated with systolic blood pressure (SBP), and this was also so after controlling for overweight and serum gamma-glutamyltranspeptidase [gamma-GT, a marker for alcohol consumption, which showed an independent association with diastolic blood pressure (DBP)]. Low assertiveness (low scores of verbal and indirect aggression) correlated with high BPs, even after controlling for other psychosocial variables. Several associations between psychosocial job variables and physiological variables were found. Among self-reported job variables, excessive 'demands' and 'bossing others' (but not 'decision latitude' or 'psychosocial conflict') were associated with high SBP. Habitual smoking of cigarettes was not associated with BP at rest, but influenced several associations between psychosocial and physiological variables. Men with high BP at rest and low plasma renin activity (PRA) reported more psychosocial problems at work and lower assertiveness than other groups.

Adult↗
PubMed1985

Pruritus during standardized mental stress. Relationship to psychoneuroendocrine and metabolic parameters.

The influence of experimentally-induced emotional stress on pruritic response of human skin was studied in healthy subjects. Experimental activation of the psychoneuroendocrine system was produced by standardized stressors, i.e. a colour-word-conflict test (Stroop-test) and a subsequent mental arithmetic problem. Pruritus was elicited by intradermal injection of histamine. Results obtained were compared with reported feelings of stress, and stress-induced physiological and biochemical changes. Reported stress levels were evaluated by a visual analogue scale. The physiological and biochemical observations included pulse rate, blood pressure, endocrine and metabolic parameters. The experimental model produced adequate psychoneuroendocrine stress reactions. Cutaneous responses to histamine remained despite this unaltered. The cutaneous responses were unrelated to reported stress levels as well as to physiological and biochemical variables prior to stressor exposure. The individual cutaneous reactions to stressor exposure were related to the adrenaline response pattern. Degree of control, ability to predict, and time limitation of the experimental situation may be important factors influencing the experimental outcome.

Adult↗
PubMed1984

Effect of graded 15(R)15 methyl prostaglandin E2 and of indomethacin on the gastric secretory and plasma gastrin response to modified shamfeeding.

Vagal stimulation by modified shamfeeding in healthy subjects induced about fourfold increases of gastric outputs of acid, chloride, sodium and potassium. Prior oral 15(R)15 methyl prostaglandin E2 inhibited dose-dependently the peak and total gastric acid response to modified shamfeeding by lowering both the secreted volumes and the acidity. The inhibition by 15 micrograms of the analogue exceeded 50% and the suppression was submaximal by 140 micrograms. Gastric output of chlorides decreased in a dose-related way. The hydrogen ion output was proportionally more reduced than the chlorides. The analogue did not affect the gastric output of sodium. Potassium decreased in a dose-related way. Indomethacin was without effect on the gastric acid response to shamfeeding but reduced the sodium output compared to in controls and in series with the analogue. Plasma gastrin was slightly but significantly elevated by the shamfeeding procedure. This elevation was absent or even reversed by 15(R)15 Me PGE2. No effect was recorded by indomethacin pretreatment. Vagal stimulation augments both the parietal and non-parietal components of the gastric secretion. Low doses of oral 15(R)15 Me PGE2 were effective in suppressing the vagally stimulated acid secretion. Neutralization by the gastric non-parietal secretion can contribute to reduce the acid response. Blocking of the prostaglandin biosynthesis decreased gastric sodium output, suggesting indirectly that endogenous prostaglandins may be involved in modulating the gastric non-parietal secretion.

Adult↗
PubMed1984

Oral glucose tolerance test in pregnancy. Evaluation of a simplified procedure.

After initial screening for gestational diabetes, 182 3-hour OGTTs in altogether 168 patients with determination of plasma glucose at 30-minute intervals were performed. Two-hour and 3-hour areas below the curve were calculated. Twenty-two patients had a reduced glucose tolerance test as judged by the 3-hour areas. Twenty of the 22 patients had a reduced glucose tolerance even according to the 2-hour areas. The correlation coefficient between the 3-hour areas and the 2-hour areas was 0.97. In 160 observations plasma glucose and capillary blood glucose were compared. The correlation coefficient between plasma glucose and capillary blood glucose concentrations was 0.99. It is concluded that the discriminatory power of the 2-hour OGTT with capillary blood glucose determinations is comparable to that of the 3-hour OGTT with venous plasma glucose determinations. The simplicity of the suggested method makes it suitable for use in instances with moderate or small laboratory resources.

Blood Glucose↗
PubMed1984

Effect of total parenteral nutrition on serum concentrations of eight proteins in Crohn's disease.

In 15 patients with Crohn's disease a study was made of the effect of total parenteral nutrition (TPN) (nil per os) on the serum concentrations of albumin, transferrin, orosomucoid, haptoglobin, alpha 1-antitrypsin, IgG, IgA, and IgM, and on the hemoglobin concentration in blood and the erythrocyte sedimentation rate. The study covered 22 periods of TPN, each of at least 21 days. At introduction of TPN one group of steroid-free patients (group I) displayed clinical and laboratory signs of severe malnutrition and a high level of activity of the disease. Another group of patients without steroid medication showed signs of incipient or mild malnutrition and mild to moderate activity (group II). The patients receiving prednisolone were assigned to a separate group (group III). During the first 3 wk of TPN the S-albumin and S-transferrin levels increased in group I, whereas the S-orosomucoid and S-alpha 1-antitrypsin concentrations decreased parallel with a clinical improvement. In groups II and III, however, there was no convincing biochemical sign of improvement during the initial 3-6 wk of TPN. In both groups I and II there was an increase in, particularly, the S-IgM level of the immunoglobulins. It is concluded that steroid-free patients with Crohn's disease displaying signs of severe malnutrition and highly active disease are likely to show biochemical and clinical evidence of improvement after 3 wk of TPN; the response to TPN is related to the initial status of the patient.

Adult↗
PubMed1984

Human creatine kinase. Isoenzymes and logistics of energy distribution.

A simple procedure to estimate creatine kinase of mitochondrial origin (CK-mit) was tested in homogenates from human myocardial and skeletal muscle. Thereafter CK-mit was estimated as the difference between the activity remaining after immunoinhibition with anit-CK-M and chromatographic isolation of CK-MB. This method was applied to selected human myocardial and skeletal muscle biopsies. These biopsies were selected on the basis of citrate synthetase activity so as to give a large range in oxidative capacity. CK-MB and CK-mit were correlated and both CK-MB and CK-mit correlated to citrate synthetase activity. The isoenzymes CK-MB and CK-mit were thus associated with the oxidative capacity of the tissue. The results confirm the energy shuttle hypothesis for CK with CK-MB located at target organelles.

Citrate (si)-Synthase↗