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Biomedical subjects

B Madsen

Publications and source records attributed to B Madsen.

At least 19 recordsLinked to original sources

Very low density lipoprotein receptor binds and mediates endocytosis of urokinase-type plasminogen activator-type-1 plasminogen activator inhibitor complex.

Very low density lipoprotein receptor (VLDL-R) was found to be expressed in bovine mammary gland and the human breast carcinoma cell line MCF-7 as an M(r) 105,000 variant, and in Chinese hamster ovary (CHO) cells transfected with human VLDL-R cDNA as an M(r) 130,000 variant. The receptor was purified by ligand affinity chromatography with immobilized M(r) 40,000 receptor-associated protein (RAP). The purified receptor was found to bind urokinase-type plasminogen activator-type-1 plasminogen activator inhibitor complex (u-PA.PAI-1), while there was no or very weak binding of active site blocked u-PA (DFP-u-PA), PAI-1 or u-PA-type-2 plasminogen activator inhibitor complex. The binding of u-PA.PAI-1 was blocked by RAP. The transfected CHO cells had an efficient, RAP-sensitive endocytosis of u-PA.PAI-1, severalfold higher than non-transfected parental CHO cells. u-PA.PAI-1 endocytosis was partially inhibited by DFP-u-PA, which blocks binding of the complex to the u-PA receptor. RAP and DFP-u-PA sensitive u-PA.PAI-1 endocytosis was also observed in MCF-7 cells, which were without detectable levels of other RAP-binding endocytosis receptors. These results show that VLDL-R represents a novel endocytosis mechanism for u-PA receptor-bound u-PA.PAI-1.

Amino Acid Sequence

[Information to cancer patients prior to participation in clinical trials. Evaluation of a structured information program].

Informing patients before starting of antineoplastic treatment is important due to the legal aspects of clinical trials and the anxiety and uncertainty felt by the patients. This study evaluates a structured information programme used in a clinical trial. Thirty-four women were interviewed three months after receiving information about trial, using a tape-recorded structured interview. Results showed that the information was well remembered. The patients were glad to have brought a relative to the two consultations, and the time for deliberation in between was well received. The patients viewed written information as an important source of reinformation. The information provided was positively evaluated. Open and detailed information did not undermine the doctor-patient relationship. Instead it allowed patients to understand and participate in treatment decision and helped to reduce their pre-therapy anxiety and uncertainty. The results support expanding structured information programmes to include not only those patients asked to participate in the clinical trial, but all patients beginning longlasting cancer therapy.

Attitude to Health

Tyrosine metabolism in users of oral contraceptives.

Brain noradrenaline takes part in the regulation of several brain functions. The formation of brain noradrenaline depends on brain tyrosine (Tyr) levels, which associates with the ratio in plasma of Tyr to other large, neutral amino acids (LNAA). Tyr metabolism has been studied in users of the new generation combined oral contraceptives (OC) and comparable controls at the follicular, mid-cycle, and luteal phases of the menstrual cycle. OC users showed significantly increased plasma Tyr transaminase activity, and significantly decreased plasma Tyr and Tyr/LNAA levels at mid-cycle and luteal phase, whereas plasma total 3-methoxy-4-hydroxyphenylglycol (MHPG) was not affected. Following an oral protein load, the area under the curve in plasma of Tyr and Tyr/LNAA in OC users at the luteal phase were 43% and 29%, respectively, of control levels. The results suggest that the decreased Tyr availability to the brain in OC users may result in a substrate-limited reduction of brain noradrenaline formation, which, secondarily, may contribute to disturbances of mood, coping mechanisms, and appetite in susceptible subjects.

Adult

Endothelin in renovascular and essential hypertension.

Immunoreactive endothelin (ir-ET) was measured in peripheral venous plasma in 12 patients with renovascular hypertension (RVH) due to unilateral renal arterial stenosis, in 12 patients with essential hypertension (EH), and in 12 control subjects (C). In the patients with RVH, ir-ET was also measured in the aorta and in both renal veins before and 1 h after 25 mg of captopril was given orally. In peripheral venous plasma, ir-ET was the same in RVH (median 1.02 pmol/l (range 0.53-1.65)) as in EH (0.96 pmol/l (0.76-1.32)) and in C (1.00 pmol/l (0.77-1.16)). In RVH, the concentrations of ir-ET decrease from the aorta to the renal vein of both the affected (0.88 pmol/l (0.54-1.28) vs 0.68 (0.51-1.24), p < 0.01) and in the unaffected kidney (0.85 pmol/l (0.62-1.38) vs 0.78 pmol/l (0.36-1.25), p < 0.01). Renal extraction of ir-ET was the same on the affected side (15.1% (-3.7-33.2)) and on the unaffected side (11.2% (0.5-46.4)). In the aorta, ir-ET was significantly lower than in peripheral venous plasma (p < 0.05). The renal handling of ir-ET did not change in response to captopril in either the affected or unaffected kidney. It is concluded that circulating levels of ir-ET are normal in renovascular hypertension associated with unilateral renal artery stenosis and in essential hypertension. There is significant renal extraction of ir-ET which is unaffected by renal artery stenosis and captopril.

Adult

Biofeedback treatment of children and adults with idiopathic detrusor instability.

In adults and children suffering from urge, urge incontinence, frequent voidings, and nocturia, urodynamic examination often confirms the diagnosis of detrusor instability. We assessed the outcome of biofeedback therapy in 15 children aged 6-12 years and 7 adults aged 20-52 years, all with cystometrically proven detrusor instability. The detrusor pressure was visually conveyed to the patient during repeated bladder fillings. The patient was instructed to interrupt detrusor pressure increments by tensing the pelvic floor musculature. None of the children were found completely cured; however, 9 showed a marked decrease in either the number of the extent of symptoms. Two children showed moderate improvement, while 4 remained unaffected by the treatment. One adult was completely cured, 2 improved moderately, and 4 showed no improvement. None of these patients were converted to stable cystometry. Upon termination of the BF treatment a follow-up study was conducted for patients exhibiting pronounced or moderate improvement. The beneficial effect was maintained except in one case.

Adult

Information for cancer patients entering a clinical trial--an evaluation of an information strategy.

Informing patients before the start of antineoplastic treatment is important due to the anxiety and uncertainty felt by the patients and the legal aspects of trials. 34 women were interviewed 3 months after receiving information. Results show that the information was well remembered, patients were glad to bring a relative, two consultations with time for deliberation were well-received and that patients viewed written information as an important reinforcement. Overall, information provided was positively evaluated. Detailed information allowed patients to understand and participate in treatment decisions, thereby reducing their pretherapy anxiety. These results support expansion of the structured information programme to include all patients about to begin long-term cancer therapy.

Adult

Effect of captopril on the renal veno-arterial gradient of erythropoietin and oxygen in unilateral renal artery disease.

Twenty-nine patients with unilateral renal artery stenosis or occlusion were investigated. The veno-arterial gradient (VA-gradient) of erythropoietin (EPO), haemoglobin oxygen saturation and plasma renin activity (PRA) was determined separately in each kidney before and 1 h after angiotensin converting enzyme inhibition (ACE-inhibition). The VA-gradient of EPO and of hemoglobin oxygen saturation were the same in the affected and unaffected kidney during basal conditions. During ACE-inhibition the VA-gradient of EPO disappeared on the affected side but not on the unaffected side. A fall in s-EPO after ACE inhibition was demonstrated in the renal vein on the affected side (-1.4 U l-1, p < 0.01), in the contralateral vein (-0.8 U l-1, p < 0.01) and in the aorta (-0.6 U l-1, p < 0.01). The O2-gradients were reduced on both sides after captopril, from 10.8-7.5% (p < 0.04) on the affected side and from 10.8-9.0% (p < 0.04) on the contralateral. It is suggested that the stimulated renin-angiotensin system may be important for EPO production in the affected kidney in unilateral renal disease.

Adult

Effect of captopril on renal extraction of renin, angiotensin II, atrial natriuretic peptide and vasopressin, and renal vein renin ratio in patients with arterial hypertension and unilateral renal artery disease.

Plasma renin activity (PRA) and plasma concentrations of angiotensin II (AngII), atrial natriuretic peptide (ANP) and arginine vasopressin (AVP) were determined in the abdominal aorta and the renal veins before and 1 h after peroral ingestion of captopril 25 mg in 29 patients with arterial hypertension and unilateral renal artery stenosis or occlusion, in order to study the effect of ACE inhibition on single-kidney extraction ratio (ER) of PRA, AngII, ANP, and AVP, and on renal vein renin ratio (RVRR). PRA was increased, AngII and ANP were reduced, and AVP unchanged after captopril. On the affected side the negative ER or PRA (-1.03) and AngII (-0.28) and the positive ER of ANP (0.25) and AVP (0.14) were not significantly changed by captopril. On the non-affected side ER of AngII and ER of ANP were significantly reduced (ER of AngII, 0.41-0.00, ER of ANP, 0.29-0.17), but ER of PRA and ER of AVP were unchanged. RVRR was not significantly changed by captopril. RVRR was greater than 1.5 in 79% of the patients before captopril, in 82% after captopril, and in 93% either before or after captopril. It is concluded that captopril reduces ER of AngII and ER of ANP on the non-affected side but not on the affected side in unilateral renal artery disease with hypertension, and that the use of RVRR both before and after captopril improves the predictive value of RVRR with regard to the diagnosis of unilateral renal artery disease.

Adult

Angiotensin-converting enzyme inhibitor renography in the diagnosis of renovascular hypertension. Studies before and after angioplasty.

Renography with [99mTc] diethylenetriaminepenta-acetate (DTPA) was performed in 26 patients with renal artery stenosis (RAS), unilateral in 15 and bilateral in 11, and in 16 patients with essential hypertension with a normal renal angiogram. Nine of the patients with unilateral RAS were restudied after a successful percutaneous transluminal renal angioplasty (PTRA), i.e. complete removal of the stenosis and a normalization of the blood pressure without antihypertensive treatment. Single-kidney [99mTc]-DTPA clearance and parenchymal mean transit time (MTT) were determined at each examination. All patients were studied on two different days using the same procedure except that captopril 25 mg was given orally before renography at the second examination. In unilateral RAS captopril reduced single-kidney [99mTc]-DTPA clearance significantly on the affected side (-42.7%, median) but not on the unaffected side (-3.2%). In bilateral RAS single-kidney [99mTc]-DTPA clearance was reduced to the greatest extent on the most affected side (-43.0%) compared with the least affected side (-17.2%). In essential hypertension no significant changes were recorded on any side (-1.5% for both). After PTRA, single-kidney [99mTc]-DTPA clearance was not significantly changed by captopril either on the previously affected side (4.3%) or on the unaffected side. MTT was significantly prolonged after captopril on the affected side in unilateral RAS and on the most affected side in bilateral RAS, whereas no significant changes were found on the unaffected side in unilateral RAS, on the least affected side in bilateral RAS, or on any side in essential hypertension.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

[Percutaneous embolization of vascular abnormalities].

In six male patients, percutaneous embolisation of symptom-producing vascular anomalies was performed with spirals or small particles. After a total of ten treatments, symptom-free states were obtained in half of the patients and definite improvement in the remainder. The results are so promising that this method of treatment will be continued.

Adolescent

Development of more potent atrial natriuretic factor (ANF) analogs.

Four modified atrial natriuretic factor (ANF) analogs were designed and synthesized by the solid-phase method. Using human ANF-(99-126) as the reference compound the receptor binding affinity and biological activity of these analogs were examined by radioreceptor assay and in vivo experiments. PLO68, a 21 amino peptide with structural modifications des-Ser103,104-[Mpr105,D-Ala107,114]APII-amide exhibited 2.5 and 2.2 fold more activity than human ANF-(99-126) in lowering blood pressure and causing natriuresis in urethane anesthetized rats. Receptor binding assays using rat lung membranes showed that PLO68 had a Kd of 200 +/- 12 pM compared to a Kd of 620 +/- 12 pM for human ANF-(99-126). Similar chemical modifications, except for substitution of glycine and alanine at the positions 115 and 118, and 120 by D-alanine resulted in three analogs PLO63 and PLO64, PLO67 respectively. PLO63, PLO64 and PLO69 had similar affinities and in vivo potency as human ANF-(99-126). These data suggest that the structural modifications made in PLO68 can cause an increase in the receptor binding ability and an enhancement of biological activities.

Amino Acid Sequence

Differentiation between renovascular and essential hypertension by means of changes in single kidney 99mTc-DTPA clearance induced by angiotensin-converting enzyme inhibition.

Blood pressure (BP), plasma renin concentration (PRC), and 99mTc-labeled diethylenetriaminepenta acetate (DTPA) renography with determination of single kidney 99mTc-DTPA clearance and parenchymal mean transit time (MTT) were measured in exactly the same way on two consecutive days in 14 patients with renovascular hypertension (RVH), unilateral renal artery stenosis in nine and bilateral stenosis in five, and ten patients with essential hypertension (EH). The examination on day 1 served as a control for day 2 during which captopril (25 mg) was given orally one hour before measurements of PRC and DTPA clearance. Blood pressure was reduced by captopril in both groups, but the maximum decrease in systolic BP was slightly more pronounced (P less than .01) in RVH (22%, median) than EH (13%). Plasma renin concentration increased to a much greater extent (P less than .01) after captopril in RVH (366%) than in EH (46%), Single kidney 99mTc-DTPA clearance was significantly (P less than .01) reduced (-39.5%) and MTT considerably prolonged (170%) on the affected/most affected side in RVH, but both parameters were only slightly changed or unchanged on the unaffected/least affected side (-6.5%, -2% respectively) and were not significantly changed in any of the sides in EH. The degree of renal artery stenosis was significantly correlated to the increase in PRC (rho = -0.786, n = 14 patients, P less than .01), to the reduction in single kidney 99mTc-DTPA clearance (rho = 0.729, n = 19 kidneys, P less than .01) and to the prolongation in MTT (rho = -0.785, n = 16 kidneys, P less than .01). By analysis of the captopril-induced changes in 99mTc-DTPA clearance and MTT, it was possible to predict the existence of a moderate to several renal artery stenosis in arterial hypertension with a very high degree of probability, and the use of changes in 99mTc-DTPA clearance and MTT after angiotensin-converting enzyme (ACE) inhibition may become a valuable tool in differentiation between RVH and EH.

Adult

Abnormal glomerular and tubular function during angiotensin converting enzyme inhibition in renovascular hypertension evaluated by the lithium clearance method.

Glomerular filtration rate (GFR) and tubular function were measured by means of the lithium clearance technique in 14 patients with renovascular hypertension (RVH) and eight patients with essential hypertension (EH) before and after oral administration of captopril 25 mg. In RVH captopril reduced 51-Cr-EDTA clearance (67.3 (median) to 47.5 ml min-1, P less than 0.01), proximal absolute reabsorption of fluid (53.9 to 41.5 ml min-1, P less than 0.01) and distal absolute reabsorption of sodium (2195 to 1402 mumol min-1, P less than 0.01), whereas proximal fractional reabsorption increased slightly (77.5 to 80.2%, P less than 0.02). In EH, however, these parameters were practically unaffected by captopril. In both RVH and EH plasma concentrations of angiotensin II and aldosterone were reduced after captopril, but atrial natriuretic peptide in plasma and urinary excretion rate of prostaglandin E2 were unchanged. Blood pressure decreased after captopril in both groups, but the maximum fall in systolic BP was more pronounced in RVH (22%) than EH (13%). It is concluded that angiotensin converting enzyme inhibition markedly reduced absolute reabsorption in both the proximal and distal tubules in RVH, in contrast to EH, predominantly due to fall in the GFR, and that the slight increase in proximal fractional reabsorption may be attributed to a reduction in the hydrostatic pressure in the peritubular vessels.

Adult

Atrial natriuretic peptide and the renal response to hypervolemia in nephrotic humans.

To elucidate the abnormality of body fluid homeostasis that attends the nephrotic syndrome, we compared the atrial hormonal and renal excretory and vasomotor responses to water immersion of nephrotic patients (N = 10) with those of healthy controls (N = 9). Nephrotics exhibited depressed baseline levels of atrial natriuretic peptide (ANP, P less than 0.05) and lower rates of urine flow and sodium excretion (P less than 0.01). Although immersion-induced hypervolemia increased plasma ANP to equivalent levels (75 +/- 19 vs. 60 +/- 6 pg/ml), the disparity in corresponding urinary flow (5 +/- 1 vs. 13 +/- 2 ml/min, P less than 0.01) and sodium excretion (171 +/- 42 vs. 540 +/- 65 muEq/min, P less than 0.01) grew larger. In contrast, immersion caused an equivalent reduction of renal vascular resistance by 16 and 17%, respectively (P less than 0.01). Despite higher renal plasma flow and lower oncotic pressure of plasma, the glomerular filtration rate remained constant during immersion in both groups. Similar constancy of fractional clearances of dextrans of graded size suggests that immersion may have lowered the glomerular transcapillary hydraulic pressure difference (delta P). We conclude that renal vasomotor responsiveness to hypervolemia is preserved in nephrotics, but that the mediatory role of ANP in this response is uncertain. By contrast, diminished responsiveness of the distal nephron to the natriuretic action of endogenous ANP could contribute to edema formation in the nephrotic syndrome.

Adolescent