[Ethanol in acute ischemic heart disease].
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Biomedical subjects
Publications and source records attributed to C G Nilsson.
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Memantine, a clinically employed drug with N-methyl-D-aspartate (NMDA) receptor antagonistic effects, dose-dependently ameliorates neurological deficits in Lewis rat experimental autoimmune encephalomyelitis (EAE). Interestingly, this therapeutic effect was not due to dampened CNS inflammation, as assessed by immunohistochemical evaluation of spinal cord tissue. Furthermore, numbers of interferon gamma (IFN gamma) mRNA expressing cells were not decreased, as assessed by in situ hybridization. Systemic immunity in terms of numbers of IFN gamma secreting cells in response to immunodominant myelin basic protein (MBP) peptides ex vivo was not reduced, and non-toxic doses of memantine did not affect lymphocyte proliferation or IFN gamma secretion in vitro. Considering these findings, we hypothesize that effector mechanisms responsible for reversible neurological deficits in EAE may involve NMDA receptors, and this highlights neurons as targets during autoimmune neuroinflammation.
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Nitric oxide (NO) donors were used to investigate the effect of NO on and the role of cyclic GMP in the regulation of human natural killer (NK) cell function. NO-producing drugs, molsidomine and its metabolite 3-morpholinesydnonimine (SIN-1), inhibited NK cell-mediated cytotoxicity significantly at 0.04-5 mM. At 1 mM, SIN-1 completely inhibited NK cell activity while molsidomine decreased NK cell-mediated cytolysis by 35% of the control value. These data suggest that NO from exogenous NO-donors may down-regulate NK cell cytotoxic function. The stimulatory effect of interferon-gamma (IFN-gamma) on human NK cell-mediated killing could not overtake the NK cell inhibition induced by the NO releasing drugs, indicating different modes of action for IFN-gamma and SIN-1. The results in the present study also showed that SIN-1 (1 mM) stimulated cyclic GMP production 37-fold in NK cells. In the presence of 0.5 mM IBMX, a phosphodiesterase inhibitor, the increase in cyclic GMP was even more pronounced, demonstrating a relation between cyclic GMP stimulation and NK cell inhibition by SIN-1. Further evidence for mediation via cyclic GMP was provided by the finding that methylene blue (20 microM), an inhibitor of soluble guanylate cyclase, decreased both the inhibition of SIN-1-induced NK cell cytotoxicity as well as cyclic GMP formation. Moreover, membrane-penetrating cyclic GMP and its analogues inhibited NK cell-mediated cytolysis significantly. Molsidomine was without effect on cyclic GMP levels. Our data indicate that cyclic GMP may play a role in human NK cell regulation and suggest that the inhibitory effect of cGMP may be elicited by NO.
Somatization is a tendency to experience and communicate psychogenic distress in the form of somatic symptoms and to seek medical help for them. Patients suffering from environmental somatization syndrome (ESS) consider their symptoms to be caused by exposure to chemical or physical components of the external environment or by ergonomic stress at work. ESS is distinguished by mental contagiousness and a tendency to cluster. Sometimes it explodes in wide-spread epidemics that may be escalated by mass-media campaigns. Extensive ESS epidemics have been connected to, i.a., arsenic, carbon monoxide ("generator gas poisoning"), mercury ("oral galvanism"), carbon-free copy papers, electromagnetic fields ("electric allergy") and repetitive movements ("repetition strain injury", RSI). The typical patient directs the interest on the external environment, refuses alternative explanations of his symptoms and abhors any suggestion of a psychogenic etiology. The community is often placed in difficult positions by lobby groups calling for drastic measures to eliminate alleged disease-inducing exposures. When hygienic evils occur simultaneously with an ESS epidemic, it is essential to strictly differ the hygienic problems from the ESS problems. If mismanaged, measures aimed at reducing hygienic inconveniences may aggravate the complex of ESS problems.
The treatment of postmenopausal symptoms was studied in 26 healthy women using a new synthetic rubber (Kraton D 2109) vaginal ring containing 53 mg of 17 beta-oestradiol. All women were postmenopausal, at least 6 months after the last vaginal bleeding and suffering from daily hot flushes. The study was conducted in a double-blind placebo-controlled intrapatient cross-over fashion, and the study period was 6 months. The rings used give an initial in vitro release rate of 0.4 mg/E2 per day. The in vitro release rate decreases to about 0.2 mg/day after 20 days and levels off asymptotically to about 0.1 mg/day after 50 days. Serum E2 levels equivalent to the follicular phase of the normal menstrual cycle were measured after 1 month's use, and serum E2 level stayed above postmenopausal levels throughout the study period. FSH was suppressed during use of the E2-releasing vaginal ring, while LH showed no statistically significant suppression in continued use. Postmenopausal complaints were recorded by Visual Analogue Scales (VAS) as judged by both the patient and the examining doctor; all complaints had favourable outcomes during use of the E2-releasing vaginal ring without deterioration of symptoms during use of the placebo ring. No serious side-effects were encountered, and the possibility of managing all postmenopausal complaints with intravaginal oestrogen treatment is discussed.
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The localisation of arteriosclerosis to foci of haemodynamic stress of sites of supporting collagen or elastic fibre deficiency illustrates the importance of mechanical factors in the fate of the smooth muscles. Excessive stress depletes stocks of ATP (adenosine triphosphate), resulting in osmotic lysis. Phosphate ions are released and precipitated in calcifications as apatite. The vascular lesion is followed by reparative and adaptive tissue inflammation. The haemodynamic stress is modified by a number of psychosocial factors, and is increased by traumatic and other injury to the ground substance. Some of the LDL (low-density lipoprotein) perfusing the intima is captured in the proteoglycan matrix, especially if the media is thickened. When cells and ground substance are lysed, fractions are incorporated in macrophages through metabolically uncontrolled receptors. Toxic oxidised LDL is then continuously ingested in the cells before they eventually die, leaving the amorphous lipid-rich mass of which an atheroma is formed. The macrophages produce free radicals which accelerate the damage and the inflammation. Thus, many factors working at different levels are involved in the aetiology of arteriosclerosis, with or without atheromatosis. The only theoretically feasible though insufficiently tested dietary recommendation for the general population would be to reduce the in vivo redox potential of food intake.
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Medical 'oophorectomy' by GnRH agonist or danazol is an effective treatment for endometriosis. Since increased bone loss is a potential risk of hypoestrogenism, we compared the effect of nafarelin and danazol treatment on bone metabolism. Twelve patients with laparoscopically confirmed endometriosis received nafarelin (400 micrograms day intranasally) and six patients danazol (600 mg day orally) for 6 months. Both treatments had already led to hypoestrogenism (E2 less than 21.6 pg/ml) after 3 months. They both were accompanied by an approximately 50% rise in 24-h urinary hydroxyproline output, suggesting accelerated bone resorption at 6 months; yet urinary calcium output did not change significantly. Serum osteocalcin rose by 80-120% and bone alkaline phosphatase activity by 34-40%, suggesting stimulated bone formation at the same time. No detectable changes ensued in cortical bone mineral content in the distal radius or in serum levels of calcium, calcitonin, parathyroid hormone, or aminoterminal propeptide of type III collagen. Three months after treatment, hydroxyproline output, serum osteocalcin and bone alkaline phosphatase were still elevated in women taking nafarelin, whereas only serum osteocalcin was elevated in women taking danazol. Our data thus suggest that bone turnover was increased during nafarelin and danazol therapy and that this effect was reversible.
It is suggested that damaged arterial smooth muscle cells (SMC) and altered structural proteins are interpreted as foreign and degraded by the complement system and by macrophages. At the same time growth factors are liberated, stimulating hyperplasia of SMC. In atheromata this proliferation may be monoclonal. The long-lived proteins in the ground substance are glucosylated by Amadori reactions leading to virtually stable compounds and to polymerization. This process is enhanced by high blood sugar and possibly by vitamin B6 deficiency. The proteoglycans adsorb lipoproteins which are transported to macrophages during the reconstruction of the wall. The combined result of all these changes is a thickened and stiff intima with decreased nutritional flow to the cells and decreased transmissibility of macrophages and other cells. In addition to antihyperlipemic treatment, arteriosclerosis prevention should include antihypertensive treatment preferably with calcium blocking or beta blocking agents or both and antidiabetic treatment, but also nutritional measures including the supply of Mg, Vitamins E and B6 and possibly nitrites.
The effects of nafarelin (400 micrograms daily; 12 patients) and danazol (600 mg daily; 6 patients) on serum lipoproteins, high density lipoprotein (HDL) subfractions, and apoproteins-A-I and -A-II were studied. Lipoproteins were fractionated by sequential flotation from samples taken before and after 1, 3, and 6 months of treatment as well as 3 months after cessation of medication. Serum concentrations of estradiol, total and free testosterone, androstenedione, and sex hormone-binding globulin were also determined. On nafarelin treatment, serum total HDL and HDL2 cholesterol concentrations increased slightly, but total and low density lipoprotein (LDL) cholesterol levels were unchanged. There was no effect on apoproteins-A-I and -A-II or on total and very low density lipoprotein (VLDL) triglyceride concentrations. During treatment with danazol, the serum levels of total HDL and HDL2 cholesterol showed profound decrease, as did all the components of HDL2, including apoprotein-A-I. Concomitantly, the total mass of LDL was increased by 25%, accounted for by parallel rises in all of the components of LDL. Total and VLDL triglyceride concentrations decreased inconsistently. Both treatments resulted in hypoestrogenism of the same degree. The steep drop in the serum sex hormone-binding globulin level reflected the androgenic effect of danazol, whereas during nafarelin treatment, serum concentrations of testosterone and androstenedione were reduced. This difference in androgenic milieu may well explain the differences in the lipid profiles. We conclude that, regarding lipid effects, nafarelin is a more favorable treatment for endometriosis than is danazol.
Nineteen adolescent girls with oligomenorrhea were studied to evaluate the effect of oral contraceptives (OCs) on hormone profiles, and 19 adolescent girls with regular menstruations served as control subjects. Serum levels of luteinizing hormone and androgens were higher in the oligomenorrheic girls than in the regularly menstruating girls. During the OC treatment the hormone levels of the oligomenorrheic girls decreased, approaching those of the control subjects. During follow-up cycle immediately after stopping the OCs the hormone levels increased rapidly, but in the oligomenorrheic girls the levels of luteinizing hormone, androstenedione, total and free testosterone were still significantly lower at the end of the post-treatment cycle than during the luteal phase of the pre-treatment cycle. The frequency of ovulation decreased to the same magnitude as reported in adults after discontinuation of OCs. No post-pill amenorrhea existed in either group of adolescents.