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Biomedical subjects

A Magnusson

Publications and source records attributed to A Magnusson.

At least 19 recordsLinked to original sources

Contrast-enhanced CT scanning in vivo for the quantification of hepatic metastases from a human colonic cancer in the nude rat.

Hepatic metastases were induced in nude rats by intraportal injection of 2.5-5.0 x 10(6) cells from the human colonic cancer cell line LS 174 T. Quantification of tumour burden, expressed as relative metastatic area, was performed by contrast-enhanced computed tomography (CT) scanning in vivo (n = 14), contrast enhanced CT scanning post mortem (n = 21) and computer-based area calculation (CBAC) (n = 21). To determine the false-positive contribution to the estimated tumour burden by the evaluation procedures themselves, six rats without metastases were assessed. The quantification in the three different assessment groups was in close accordance in animals with an intermediate or extensive metastatic burden, but not in rats with a minor (< 4%) tumour burden. The results indicate that contrast-enhanced CT scanning can be used in this model to quantify hepatic metastases, except in animals with few and small lesions. Furthermore, the results suggest a potential for the assessment of therapeutic response by repeated contrast-enhanced CT scanning in vivo, as well as prospects for a corresponding evaluation in man.

Animals

Treatment of seasonal affective disorder with high-intensity light. A phototherapy study with an Icelandic group of patients.

The standard phototherapy procedure for seasonal affective disorder (SAD) has been to expose patients to 2500 lux light intensity for 2 h. This study investigated whether high-intensity light treatment with a brief exposure time would relieve symptoms of SAD. Ten SAD patients were randomly assigned to 40-min exposure to 10,000 lux white light or to 400 lux red light which served as placebo. Each patient received treatment for 8 days, and after a wash-out period was crossed over to the other treatment condition. Depression was assessed by the 21-item HDRS and SIGH-SAD by a blind rater and the patients completed the BDI for self-assessment. Significantly greater improvement was found with 10,000 lux treatment than with the placebo (P = 0.011, P = 0.017 and P = 0.028 for SIGH-SAD, HDRS and BDI respectively). The 10,000 lux therapy improved the SIGH-SAD score by an average of 16.1 while the average improvement on placebo treatment was 5.0. The patients were rated again the following summer; most of them were the symptomless. Those patients who improved most on phototherapy also tended to improve most during the summer.

Adult

A placebo-controlled trial of flumazenil given by continuous infusion in severe benzodiazepine overdosage.

A controlled trial was performed to study the effect and any adverse reactions of continuously infused flumazenil in severe benzodiazepine overdosage. The study comprised 51 adults admitted to an intensive care unit with poisoning. Enrollment criteria were unconsciousness on admission and a clear response within 5 min after an i.v. bolus injection of 1 mg flumazenil. The level of consciousness was assessed according to a modified Glasgow coma scale immediately before and at defined intervals up to 12 h after injection. A double-blind infusion was started 15 min after the bolus injection and administered for 5 h. The patients were randomly allocated to one of three groups: a group given flumazenil 0.5 mg/h, a group given flumazenil 0.1 mg/h and a placebo group. The groups were comparable in age, sex and toxicological laboratory results. There were no significant differences between the groups in the average coma score on admission or 15 min after the bolus injection. In the flumazenil 0.5 mg/h group the level of consciousness remained unchanged between the 15-min recording and the subsequent assessments. In the two other groups the level of consciousness decreased significantly during the course of the infusion. The infusions were well tolerated. It is concluded that a continuous infusion of 0.5 mg of flumazenil per hour can prevent relapse into coma in patients with severe benzodiazepine poisoning aroused with a single injection of the antagonist.

Adolescent

Considerations for the treatment of ethylene glycol poisoning based on analysis of two cases.

The clinical picture as well as the principles of treatment in ethylene glycol poisoning differ with the time after ingestion. These time-related differences are illustrated by two case reports. During the first hours of ethylene glycol poisoning, the patient suffers from drunkenness, vomiting and somnolence due to the intoxicant effect of ethylene glycol on the central nervous system. In the following hours a poisoning with glycolate and oxalate develops, with increasing acidosis, renal and brain damage. A patient admitted within a few hours of an overdose, with no or only slight metabolic acidosis, may be successfully treated with ethanol. If the serum concentration of ethylene glycol is very high, hemodialysis may be deferred until the necessary staff and equipment are available. If the patient is admitted with severe metabolic acidosis, hemodialysis must be started immediately. The need for ethanol administration during hemodialysis merits reevaluation.

Acidosis

Assay of theophylline: in vivo and in vitro evaluation of dry chemistry and immunoassay versus high-performance liquid chromatography.

In the last decade, kits using dry chemistry have been introduced for analysis of theophylline in biological fluids. We investigated the performance of Ames Seralyzer and Kodak Ektachem 700XR. They were compared to an enzyme immunotechnique (Syva EMIT) and high-performance liquid chromatography (HPLC). Mixed sera from theophylline-treated patients at concentrations of 20, 50, and 80 mumol/L were used. We also investigated the performance of the various methods when assaying theophylline concentrations obtained from individual patients treated or intoxicated with theophylline (n = 35 patients). In within-day analysis, the EMIT method deviated +1- + 9%. the Ektachem 700XR method deviated +2- + 8%, and the Seralyzer method deviated at least + 18% compared to HPLC. Within-day variability was low for all 4 methods. A similar pattern was seen during between-day assay. In five intoxicated patients, EMIT, Seralyzer and Ektachem 700XR deviated at least + 10% compared to HPLC. The Ektachem 700XR method deviated +16- + 36% compared to HPLC, when samples of 240 mumol/L and above were analyzed. Our study shows that theophylline assay kits cannot be recommended in drug analytical laboratories unless specific backup methods are available. EMIT showed the best performance compared to HPLC. Ektachem 700XR gave good results at therapeutic drug concentrations, but was not reliable in intoxicated patients or in those with decreased kidney function.

Adult

Superparamagnetic particles as oral contrast medium in MR imaging of malignant lymphoma.

Non-biodegradable superparamagnetic particles, in plain and viscous aqueous suspensions, were used as an oral contrast medium in 34 patients with known or suspected malignant lymphoma. The contrast effect, the occurrence of artifacts, and the distribution were evaluated in the plain and the viscous aqueous suspensions, and the diagnostic information received from abdominal MR examinations performed without bowel contrast medium was compared with that of post-contrast examinations. Magnetic particles in the concentration of 0.5 g/l displayed a good contrast effect at 0.5 T, and helped in differentiating the intestine from adjacent tissues, resulting in increased diagnostic information in abdominal MR imaging. In the patients given the viscous aqueous suspension the occurrence of artifacts caused by the magnetic particles decreased considerably, and the distribution was homogeneous and improved compared with that in patients given the plain aqueous suspension.

Abdomen

Naturally occurring HIV-1 isolates with differences in replicative capacity are distinguished by in situ hybridization of infected cells.

Replication of human immunodeficiency virus type 1 (HIV-1) isolates in peripheral blood mononuclear cells (PBMC) has been studied by in situ hybridization using the riboprobe BH10-R3 from HTLV-IIIB. Two series of isolates were tested: (a) 20 isolates from individuals with varying severity of HIV-1 infection and (b) sequential isolates from 5 subjects showing signs of clinical progression over a 45 month observation period. The results show that HIV-1 isolates with distinct replicative capacity can be distinguished by the intensity of radioactive labeling over single infected cells after in situ hybridization. Sequential isolates from patients with clinically progressive HIV-1 infection show a gradual increase in replicative capacity over time. In PBMC cultures infected with such sequential isolates, intensity of radioactive label over single infected cells increases and is strongest with isolates obtained at the time of low CD4 counts in blood. The results suggest that the restriction of virus replication that operates in the early stages of HIV-1 infection is gradually lost with progression of the disease.

HIV Infections

Neuroendocrine pancreatic tumours: clinical presentation, biochemical and histopathological findings in 84 patients.

A prospective study has been performed on 84 patients with endocrine pancreatic tumours evaluated at the Medical Department in Uppsala. Available information concerning the patients' presenting symptoms, age at diagnosis, clinical syndrome, tumour location, location of metastases, diagnostic radiology, biochemical and histopathological findings has been analysed. Our results indicate that most patients initially show rather vague and non-specific symptoms, with dyspepsia and pain being the most frequent presenting features. The median delay between appearance of the first symptom and diagnosis was 2 years; the delay was 35 months in sporadic cases and 14.5 months in familial cases. In spite of improvements in diagnostic methods, the median age at diagnosis (53 years) has not been reduced, and most patients are encountered when the tumour has reached an advanced stage. There is a need for a method of screening patients with still uncharacteristic abdominal symptoms for a neuroendocrine tumour. The presence of elevated levels of plasma chromogranin in all patients with a proven tumour suggests that such possibilities exist, and the use of this biochemical marker in the future might reduce the age at diagnosis and thus improve the likelihood of cure and survival of patients with endocrine pancreatic tumours.

Adenoma, Islet Cell

Use of cell culture to predict toxicity of solid materials in blood contact.

A comparison was made, for in vitro assessment of toxicity, between six different procedures to extract biomaterials. A new method was developed, with a special insert inside the tissue culture well, that allows relevant contact between cells and material without disturbing physical contact. To predict the toxicity of materials in blood contact, our results suggest that two simple methods ought to be used, one based on water eluates and the other on contact between cells and material.

Animals

Preoperative localization of endocrine pancreatic tumours by intra-arterial dynamic computed tomography.

Eleven patients with biochemically confirmed endocrine pancreatic tumours were examined with intra-arterial (i.a.) dynamic computed tomography (CT) and angiography preoperatively. Seven of the patients suffered from the multiple endocrine neoplasia type 1 (MEN-1) syndrome. All patients were operated upon and surgical palpation and ultrasound were the peroperative localization methods. Of the 33 tumours which were found at histopathologic analysis of the resected specimens in the 11 patients, 7 tumours in 7 patients were correctly localized by both i.a. dynamic CT and angiography. Six patients with MEN-1 syndrome had multiple tumours and this group of patients together had 28 tumours, of which 5 (18%) were localized preoperatively by both CT and angiography. I.a. dynamic CT, with the technique used by us, does not seem to improve the localization of endocrine pancreatic tumours, especially in the rare group of MEN-1 patients, as compared with angiography.

Adult

Biochemical evidence for the GABA regulation of vasopressin levels in microdissected brain structures after servo-controlled hypotension.

Discrete brain structures were analysed for gamma-aminobutyric acid (GABA) and vasopressin content in normo- and hypotensive rats treated with the glutamic acid decarboxylase inhibitor, 3-mercaptopropionic acid (MPA) and the GABAA agonist muscimol. In the normotensive group treated with MPA only, the concentration of vasopressin increased in the supraoptic nucleus, indicating an inhibitory role for GABA. In the hypotensive group a rise in the vasopressin level in the nucleus of the solitary tract was detected and the GABA level decreased in the supraoptic nucleus. Muscimol decreased the concentration of vasopressin in the nucleus of the solitary tract. The changes in the concentration of vasopressin may be a result of increased or decreased activation of the GABAergic system. The results show that the GABA- and vasopressinergic systems somehow interact although the more precise way of action remains to be clarified.

3-Mercaptopropionic Acid

Treatment of malignant carcinoid tumors with recombinant interferon alfa-2b: development of neutralizing interferon antibodies and possible loss of antitumor activity.

Twenty patients with malignant carcinoid tumors were treated for 6 months with recombinant interferon alfa-2b (IFN alpha-2b; Intron-A; Schering Corp., Bloomfield, NJ) at a mean dose of 5.9 megaunits three times per week. Eleven of the 20 patients (55%) had a greater than 50% reduction of tumor markers (urinary 5-hydroxyindoleacetic acid or plasma neuropeptide K), showing objective tumor response. Six patients (30%) had stable disease with no significant change in tumor markers or tumor size, and three (15%) had progressive disease with an increase in tumor markers and size. These results are similar to those reported earlier for treatment with natural leukocyte IFN in patients with carcinoid tumors. Only two patients (35%) had a slight reduction of tumor size after 6 months of treatment. Three patients developed neutralizing antibodies to IFN alpha-2b. Two of these patients initially showed an objective response, which lasted until IFN antibodies developed. In one of these patients, a change to human leukocyte IFN resulted in normalization of antibody titers within 3 months, and the patient had a second objective clinical response. There was no correlation between development of IFN antibodies and development of autoimmune phenomena such as increased titers of antinuclear antibodies or thyroid autoantibodies. IFN alpha-2b seems to be as potent as human leukocyte IFN in the treatment of patients with malignant carcinoid tumors, but it is important to recognize that antibodies neutralizing IFN may develop in some patients, with concomitant loss of antitumor effects. A change to natural leukocyte IFN might be beneficial in these patients.

Aged

Fluoroscopic measurement of tibial torsion in adults. A comparison of three methods.

Three methods based on the fluoroscopic technique for measurement of tibial torsion were analyzed. The measurements were performed bilaterally in 100 normal adults. The values for bilateral tibial torsion were recorded and the values for the difference in torsion between the right and left tibia were calculated. The standard error of all investigated methods was found to be lower than published figures for computerized tomography and ultrasonic methods. The method found to be most convenient for routine use also presented the best repeatability. With this method, the standard error of a single determination of tibial torsion was estimated to be 0.7 degrees.

Adolescent