Biomedical subjects
E Agner
Publications and source records attributed to E Agner.
[Cholesterol should be treated seriously].
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Multiple angiolipomata treated with intravenous infusions of lignocaine.
A 54-year-old woman with multiple tender angiolipomata was treated with intravenous infusions of lignocaine (5 mg/kg) in saline in a double-blind trial. The pain disappeared but reappeared gradually 3 weeks later. Central mechanisms may explain the mode of action of lignocaine. Infusions should be carried out during cardiac monitoring.
Antihypertensive therapy and blood lipids: ACE inhibitors.
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[Can it be proved that antihypertensive treatment has any benefits?].
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[Economic consequences and human aspects of antihypertensive treatment].
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Coronary and skeletal muscle enzyme changes during a 14 km run.
Increasing coronary enzyme values have previously been demonstrated after physical exercise. In the present study serum values of aspartate aminotransferase (ASAT), lactate dehydrogenase (LDH), LDH isoenzymes, creatinine kinase (CK), and the myocardial-bound fraction of this enzyme (CK-MB) were measured in a random sample of healthy non-smoking, physically fit men before and immediately after a competitional 14 km run. All enzyme values increased during the run, ASAT by 7%, LDH by 25%, CK by 38%, and CK-MB by 53%. Measurement of LDH isoenzymes showed special increments of the non-cardiac fractions. However, absolute increments of the cardiac fractions of the LDH isoenzymes together with other serum enzyme elevations do not exclude a cardiac source of enzyme release during and following physical exercise.
Non-chromogenic peptide substrates for detection of enzymes by means of capacitance changes at metal electrodes.
A new type of substrate for enzyme detection has been developed. The substrate is non-chromogenic and is used in an assay method based on electrode adsorption. The rate of change in the electric capacitance of the electrode is monitored and taken as a measure of the substrate adsorption. Substrate adsorption is in turn proportional to substrate bulk concentration and thus subject to changes by enzymes. The new substrate introduces a new concept in enzyme detection: as it is non-chromogenic it may contain appropriate amino acids on both sides of the bond subject to enzymatic cleavage.
The endoscopic diagnosis of duodenal ulcer disease. A randomized clinical trial of bias and of interobserver variation.
In a randomized design we examined whether endoscopists are biased by knowledge of the radiologic diagnosis of duodenal ulcer and deformity of the duodenal bulb when recording the corresponding endoscopic diagnoses. A total of 156 patients had a barium meal and were subsequently randomized into 2 groups. In 74 of the cases the 2 endoscopists knew the result of the X-ray examination when doing the endoscopy; in 82 of the cases they did not. One endoscopist was significantly biased by his knowledge of the radiologic diagnosis of deformity of the duodenal bulb. Neither of the endoscopists was biased by his knowledge of the radiologic diagnosis of duodenal ulcer. In addition, the interobserver variation between the two endoscopists with regard to the endoscopic diagnoses of duodenal ulcer, deformity of the duodenal bulb, and duodenitis was examined. The interobserver variation was expressed by the overall agreement and by the kappa statistics, which adjusts the overall agreement for expected chance agreement. For duodenal ulcer, deformity of the duodenal bulb, and duodenitis, the overall agreements and kappa values were 0.91, 0.78, and 0.75, and 0.54, 0.42, and 0.33, respectively.
[Weil's disease with multiple organ failure and ischemia of the colon].
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Smoking and health in old age. A ten-year follow-up study.
The implications for health of smoking habits at entry were evaluated in a 10-year longitudinal study of a population of men and women aged exactly 70 at entry and otherwise selected only according to geography. Seventy-six per cent of the men and 39% of the women were smokers at 70, 32% of the male and 20% of the female smokers were inhalers. In men, heavy smoking (greater than or equal to 15 g tobacco per day and inhalation) was statistically associated with low systolic blood pressure, intermittent claudication, chronic bronchitis, low body mass index and low serum insulin, but not with forced expiratory volume in first second (FEV1). In the 10-year follow-up period heavy smoking in men was associated with excess total mortality, excess mortality from malignant neoplasms, excess mortality from non-malignant pulmonary diseases and increased decrease in FEV1. In women, but not in men, inhalation was statistically associated with excess total mortality.
Haemodynamic effects of single-dose felodipine in normal man.
The haemodynamic effects of an oral solution of 15 mg felodipine were studied in 8 healthy males. Maximal plasma concentrations of felodipine were seen 30 to 40 minutes after administration, when significant decreases in diastolic and mean blood pressures were noted. Heart rate increased maximally by 45% after 30 minutes, accompanied by a 57% increase in cardiac output and 175% increase in forearm blood flow. Total peripheral resistance decreased by 40% and forearm vascular resistance by 66%. Apparent hepatic blood flow was unchanged.
The endoscopic diagnosis of gastric ulcer. A randomized clinical trial of interobserver variation and bias induced by knowledge of the radiological diagnosis.
A critical evaluation of the endoscopic diagnosis of gastric ulcer was carried out. In a randomized design it was elucidated whether endoscopists are biased by knowledge of the radiological diagnosis when interpreting their endoscopic findings. In addition, the interobserver variation of the endoscopic diagnosis was determined. A total of 156 patients had a barium-meal examination and were subsequently endoscoped by the same two physicians in one session. Before the endoscopy, the patients were randomized in two groups. In 74 patients the physicians knew the radiologic result at the endoscopy; in 82 they did not. One endoscopist was significantly influenced by his knowledge of the radiological diagnosis. The interobserver variation, expressed as the kappa coefficient, was 0.54 and 0.60, respectively, in the two groups. The disagreement especially concerned small ulcers.
Some cardiovascular risk markers are also important in old age.
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Leg muscle circulation by 133Xenon clearance as a predictor of cardiovascular disease in an aged population.
In a 10-year cardiovascular survey of an unselected population aged 70 at entry. 133Xenon clearance was carried out in the anterior tibial muscle in both legs after maximal exercise during ischaemia in 211 men and 166 women. The maximal blood flow and the delay time (Ti) until this was achieved were measured. Using multivariate Cox's regression analyses with mortality from cardiovascular diseases (CVD) and CVD events in the eighth decade as end-points, and maximal blood flow, Ti, distal pulse abnormality and intermittent claudication as possible predictors, high Ti was found to be an independent predictor of both end-points in both sexes. In further multivariate Cox's regression analyses including other possible CVD risk markers, high Ti was of individual predictive value for excess total mortality, excess CVD mortality and excess CVD events in both sexes. It is concluded that high Ti by 133Xenon clearance at the age of 70 is a powerful predictor of future CVD events.
Additional antacid does not increase the effect of cimetidine in gastric ulcer disease.
Eighty-one adult outpatients with endoscopically confirmed gastric ulceration were treated with cimetidine (1 g/day). In addition, the patients were allocated at random to either intensive antacid treatment or placebo treatment. This part of the study was double-blind. It was found that additional antacid treatment had no effect on ulcer healing and symptoms in cimetidine-treated gastric ulcer patients. The results were similar in patients with corpus ulcers and patients with prepyloric ulcers.
A reevaluation of atrial fibrillation in thyrotoxicosis.
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The electrode adsorption method for determination of enzyme activity: a study of substrate requirements.
The electrode adsorption method for the determination of enzyme activity requires substrates that, besides having good kinetics constants for the enzyme, also show good adsorption/desorption kinetics to the electrode surface and adsorb in such a way that they change the double-layer capacitance of the electrode. A series of peptide substrates containing one to three aromatic groups has been synthesized. Our results show that the aromatic groups are of crucial importance for the capacitance change caused by the adsorbing/desorbing substrate. Thus, the tripeptide substrate, Bz-Phe(NO2)-Val-Arg-pNA, with three aromatic groups is superior to the other synthesized substrates containing only one or two aromatic groups. Our desorption experiments show that several factors determine the rate of capacitance increase observed when thrombin is added to a substrate solution in equilibrium with a substrate-covered electrode. The kinetic constants of the substrate determine how the substrate concentration in the solution decreases and, consequently, determine the spontaneous desorption measured as capacitance increase. Thrombin does not seem to split adsorbed substrate molecules but it adsorbs to the substrate-covered surface and in that way causes a capacitance decrease counteracting the change caused by desorption of substrate.