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Biomedical subjects

B Thorell

Publications and source records attributed to B Thorell.

At least 19 recordsLinked to original sources
PubMed1994

Implementation of a structured care programme for diabetes mellitus in a defined population in mid-Sweden.

A local programme for diabetes care, based on the Swedish national programme, was introduced in the Köping-Arboga-Kungsör area in mid-Sweden in 1984. Before the programme was implemented, a survey of diabetes care was performed in the area. Two years later, a new survey involving 92% of 1253 diabetes patients in the area was performed to see if the programme was associated with an improved level of care, more optimal treatment and better metabolic control. A significant number of Type 2 patients were referred from hospital outpatient clinics to the primary health care centres. The proportion of patients on diet only increased from 26% to 30% and the average number of daily injections among insulin-treated patients increased. The average number of check-ups by a doctor decreased and the number of check-ups by specially trained nurses increased. Overall, the number of check-ups per year increased from 3.1 to 3.8. The proportion of the patients fulfilling the HbA1c criterion of 'good metabolic control' (< or = 6.0%) increased significantly, as did those fulfilling the fasting blood glucose criterion (< or = 7.0 mmol l-1). Serum cholesterol and serum triglyceride levels increased. Relative weight, blood pressure, smoking habits, and exercise habits were unchanged. In conclusion, the quality of diabetes care was improved after the diabetes care programme was implemented.

Adult↗
PubMed1994

Intervention against ischaemic heart disease risk factors in primary health care in a semi-rural community. The population study "50-year-old people in Kungsör".

OBJECTIVE: To see whether a program for screening and intervention against ischaemic heart disease (IHD) risk factors could be integrated into the ordinary work of a primary health care centre. DESIGN: Longitudinal population study with baseline screening, intervention, and one-year follow up. SETTING: Kungsör, a semi-rural community in mid-Sweden. PARTICIPANTS: All 50-year-old men and women in Kungsör. MAIN OUTCOME MEASURES: Feasibility, participation rate, change of traditional IHD risk factors and self-assessed well-being measures. RESULTS: Blood pressure and serum cholesterol were significantly reduced. Smoking rates and BMI were not affected. The advice given had the same effect, whether given by the doctor or the nurse. Videotaped information had no further effect on the risk factor levels. There was no obvious evidence of negative psychological effects of screening and intervention. CONCLUSIONS: Primary health care provided an excellent base for the study and the project could be performed within the ordinary setting. The risk reduction was of a similar magnitude to that in the large-scale preventive trials without any evidence of negative psychological effects of screening and intervention.

Cohort Studies↗
PubMed1993

Myocardial infarction risk factors and well-being among 50-year-old women before and after the menopause. The population study "50-year-old people in Kungsör".

OBJECTIVE: To examine whether early menopause has a negative influence on the traditional ischaemic heart disease (IHD) risk factor pattern and on well-being. DESIGN: Cross-sectional population study. SETTING: Kungsör, a semirural community in mid-Sweden. PARTICIPANTS: All 155 women in Kungsör who became 50 years old in 1984-7. MAIN OUTCOME MEASURES: Traditional IHD risk factors and self assessed well-being measures. RESULTS: Women who smoked had an earlier menopause than others. Postmenopausal women had significantly higher serum cholesterol levels (and haemoglobin levels), and more sleep disturbances than premenopausal women. There were no significant differences in other self-rated well-being, but home and family situation, patience, anxiety, and sleep disturbances tended to become worse with time from menopause. CONCLUSIONS: These findings may be interpreted as evidence indicating that the menopause affects the IHD risk factor profile and well-being negatively.

Alcohol Drinking↗
PubMed1991

Myocardial infarction risk factors in a semirural area in mid-Sweden. The population study "50-year-old people in Kungsör".

The mortality from ischaemic heart disease is higher in predominantly rural northern and western Sweden than in the more urban eastern and southern districts. This study was performed in a small semirural area in mid-Sweden with lower mortality from ischaemic heart disease in middle-aged men and higher mortality in middle-aged women than the national average. Smoking habits, serum cholesterol, and blood pressure were measured in all 50-year-old men and women in the community (n = 314) during a four-year period. In addition, the feasibility of using the local health care centre as a base for the study was tested. The health centre provided an excellent base for this population study. The non-response rate was less than 3%, indicating that using local facilities and staff well known to the population might be an advantage. The risk factor levels seemed to be higher in Kungsör than in Uppsala, a community with low mortality from ischaemic heart diseases. The differences in risk factor levels could explain some, but not all of the differences in mortality from ischaemic heart diseases. Thus, other risk factors appear to be operating as well.

Blood Pressure↗
PubMed1990

Well-being among 50-year-old people. The population study "50-year-old people in Kungsör".

Self-assessed well-being has been shown to be related to earlier medical events and to be a predictor of mortality. 50-year-old men and women (n = 314) in Kungsör were invited to an examination for traditional risk factors for cardiovascular diseases and different aspects of self-assessed well-being. The differences between men and women concerning their well-being could not explain the differences in the expected mortality between the sexes. A well-developed social network and physical exercise were the most positive determinants of well-being, while drug intake, angina pectoris, and smoking were the most negative.

Anxiety↗
PubMed1983

Metabolic control and compartmentation in single living cells.

Microspectrofluorometry of cell coenzymes (NAD(P)H, flavins) in conjunction with sequential microinjections into the same cell of metabolites and modifiers, reveals aspects of the regulatory mechanisms of transient redox changes of mitochondrial and extramitochondrial nicotinamide adenine dinucleotides. The injection of ADP in the course of an NAD(P)H transient produced by glycolytic (e.g. glucose 6-phosphate, G6P) or mitochondrial (e.g. malate) substrate leads to sharp reoxidation (state III, Chance and Williams, 1955), followed by a spontaneous state III to IV transition, and an ultimate return to original redox steady state. The response to ADP alone is biphasic, i.e. a small oxidation-reduction transient followed by a larger reverse transient. Similarities between responses to injected ATP and ADP suggest possible intracellular interconversions. Sequential injections of glycolytic and Krebs cycle substrates into the same cell, produce a two-step NAD(P) response, possibly revealing the intracellular compartmentation of this coenzyme. A two-step NAD(P)H response to sequentially injected fructose 1,6-diphosphate and G6P indicates the dynamic or even structural compartmentation of glycolytic phosphate esters in separate intracellular pools. The intracellular regulation and compartmentation of bioenergetic pathways and cell-to-cell metabolic inhomogeneities provide the basis on which the quantitative biochemistry of the intact living cell may be reconciled with these in situ findings.

Adenosine Diphosphate↗
PubMed1983

Flow-cytometric monitoring of intracellular flavins simultaneously with NAD(P)H levels.

A cytofluorimeter is described, using the combination of Argon UV (351-363 nm) and Argon Blue (488 nm) lasers. The dual excitation makes it possible to monitor simultaneously the redox state of flavins and NAD(P)H as indicative of cell metabolic state. Light scatter, absorption, and staining with exogenous fluorescent dyes can add additional information. Thus, a five-parameter flow analysis becomes possible. The present paper describes flavin and NAD(P)H measurements on isolated rat liver cells and mouse bone marrow.

Animals↗
PubMed1982

The differential effects of the carcinogen dimethylnitrosamine on isocitrate and 6-phosphogluconate metabolism in single intact cells.

A microspectrofluorimetric study is made of the influence of dimethylnitrosamine on NADP reduction, following sequential microinjections into the same L cell, of two substrates: (1) isocitrate, with activity of isocitrate dehydrogenase both in the extramitochondrial and intramitochondrial compartments, (2) 6-phosphogluconate, with activity of the dehydrogenase in the extramitochondrial compartment. In control L cells a two-step reduction of NAD(P) is obtained followed by relatively slow reoxidation. In the minutes which follow addition of carcinogen, e.g., dimethylnitrosamine, to the cell medium the isocitrate and 6-phosphogluconate-induced transient NADP reoxidation is decreased in magnitude compared to control, while the rate constant of NADPH reoxidation is considerably accelerated, possibly due to requirements at the level of the microsomal metabolizing system. Observation within the first hour of carcinogen addition suggest an interesting system for evaluating the immediate actions of carcinogens at extranuclear sites: i.e., a comparative study of NADP reduction-reoxidation rate constants via injection of substrates for extra- vs. intramitochondrial pathways.

Animals↗
PubMed1982

Design and synthesis of new reactive fluorescent dyes for cytofluorometry.

Our purpose has been to synthesize reactive fluorescent compounds with different excitation and/or emission spectra that can be used for multiple fluorescence analysis in combination with the "natural" cell fluorescence exhibited by reduced coenzyme (NAD(P)H) or flavins. Synthesis of condensation products of p-bis(2-chloroethyl)-amino-benzaldehyde is described. Their absorption spectra range from 360 to 480 nm and their emission spectra lie between 520 and 590 mm. Examples of cytological applications are given.

Chemical Phenomena↗
PubMed1981

Flow cytometric analysis of cellular endogenous fluorescence simultaneously with emission from exogenous fluorochromes, light scatter and absorption.

A cytofluorimeter capable of simultaneous 4-parameter analysis (i.e., endogenous fluorescence (NAD(P)H), exogenous fluorescent dyes, absorption and small angle scatter) is described. Analyses have been performed on isolated rat liver cells, white blood cells, bone marrow, thymus cells and yeast under different metabolic states. This allows correlations between cell function and concentration of cell substances, size, refractive indices, etc. Kinetic measurements are also possible.

Animals↗
PubMed1980

Multichannel analysis of intracellular control and intercellular transfer of molecules.

The metabolic regulation and exchanges within intracellular organelles or a cell cluster are studied by multichannel microfluorometry and microinjection of metabolites or tracers. The determination of structure-function relationships relies on the retrieval of cells after microfluorometry, for subsequent morphological evaluation. Rate constants of coenzyme reduction-reoxidation were deduced from a mathematical model of NAD(P) in equilibrium with NAD(P)H transients due to microinjection of metabolites into cultured cells belonging to a variety of normal or malignant lines. Nuclear and cytoplasmic sites operate synchronously or not, depending upon metabolic demand or pathological alterations. Intercellular transit times are determined for tracers and metabolites. Within cell clusters 'communicating territories' are described, which can show metabolically a multicellular integrated state. Microfluorometry in conjunction with ultrastructural and other studies can be used to develop a cybernetic model of the living cell, also yielding dynamic models of cooperative and regulatory interactions between different kinds of specialised cells within a cell cluster.

Animals↗
PubMed1979

Intercellular communication in pancreatic islet monolayer cultures: a microfluorometric study.

Single islet cells in monolayer cultures of neonatal rat pancreas were microinjected with fluorescein and scanned topographically by microfluorometry. Fluorescein spread from an injected islet cell directly into neighboring islet cells, and, in the presence of 16.7 millimolar glucose, significantly more islet cells communicated with the injected cell than in glucose-free medium. Islet cells were also microinjected with glycolytic substrates and activators that produced transient changes in cellular levels of reduced pyridine nucleotides-nicotinamide adenine dinucleotide and nicotinamide adenine dinucleotide phosphate [NAD(P)H]. Changes in NAD(P)H fluorescence were observed in islet cells incubated first for 18 hours in very low glucose concentrations and then in a glucose-free medium and injected with glycolytic substrates and activators; however, little change of fluorescence occurred in adjacent islet cells. In contrast, after adding 16.7 millimolar glucose to the medium, injection of glycolytic substrates and activators produced transient changes in NAD(P)H fluorescence in the injected cell and in neighboring cells.

Animals↗