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Biomedical subjects

G Karlström

Publications and source records attributed to G Karlström.

At least 19 recordsLinked to original sources

Lattice model calculations of interactions between proteins and surface grafted polymers with tethered affinity ligands.

Monte Carlo calculations of protein binding to affinity ligands tethered to a surface by polymers have been done and analyzed with statistical mechanical perturbation theory. The interaction of the polymers with the surface, the solvent and the protein has been varied. Different solution conditions of the polymers have been investigated, varying from collapsed polymer structures on a surface to structures extending out in the solution (athermic condition) or to mushroom like structures (hydrophobic polymers grafted on hydrophilic surface). The variation in binding of model proteins of different sizes and interactions with polymers has been studied. In general, smaller proteins bind better than larger proteins. Two types of polymer collapses have been studied. One type is due to increased polymer-surface attraction. The second type is due to increased polymer-self attraction. In the former case the binding, as a function of degree of collapse, decreases monotonically except for small proteins with attraction to the polymer. For collapses of the second type the loss of binding goes through a maximum except for large proteins.

Journal Article↗

Regional renal haemodynamics of angiotensin II infusion under prostaglandin, kinin or converting enzyme inhibition in the Wistar rat.

AIMS: Renal medullary blood flow is important in blood pressure regulation and is surprisingly unaffected by the vasoconstrictor action of angiotensin II (Ang II). This study tested if the effect of Ang II on the renal papillary circulation is modulated by bradykinins, prostaglandins or NO (NO). In anaesthetised Wistar rats, total renal blood flow (RBF) was measured, as was cortical (CBF) and papillary (PBF) blood flow, using the laser-Doppler technique, in responses to Ang II (30 ng kg(-1) min(-1)) alone and after ACE inhibition (enalapril) or bradykinin/prostaglandin synthesis inhibition (ketoprofen, aprotinin). PBF was also measured after blockade of NO formation with or without pretreatment with an Ang II receptor antagonist (losartan). MAJOR FINDINGS: (i) PBF did not change in response to Ang II infusion but MAP increased (+ 10%) and RBF and CBF decreased. (ii) Treatment with aprotinin and ketoprofen left MAP, RBF and CBF unchanged but decreased PBF. Ang II did not decrease PBF further but a significant increase in MAP was seen. (iii) Enalapril treatment left PBF unchanged but decreased MAP and increased RBF and CBF. When Ang II was infused PBF and MAP increased markedly. (iv) L-NAME reduced PBF independently of losartan treatment. PRINCIPAL CONCLUSION: Bradykinin and prostaglandins do not appear to cause the lack of renal papillary vasoconstriction to Ang II. However, the increase in PBF to Ang II seen after enalapril treatment suggests that enalapril treatment, possibly via its effects on kinin breakdown and subsequent NO formation, might affect the sensitivity of renal papillary autoregulation. This may be an important aspect of the blood pressure lowering effect of ACE inhibitors.

Angiotensin II↗

Effects on regional renal blood flow when unclipping a two-kidney, one-clip hypertensive Wistar rat during renal nerve stimulation.

Blood pressure (BP) is rapidly normalized when removing the obstruction from the renal artery of a two-kidney, one-clip renovascular hypertensive rat (unclipping). This study tested whether efferent renal nerve stimulation (ERNS) of the unclipped kidney affects this drop in BP or the associated changes in diuresis-natriuresis and regional renal blood flow. Three groups of anesthetized renovascular hypertensive Wistar rats were studied: 1) W(C) (time control); 2) W(UC) (unclipped after 30 min); and 3) W(UC+NS) (unclipped after 30 min, with ERNS at 5 Hz for 2 h). Renal excretion and regional hemodynamics (laser Doppler) were monitored in the unclipped kidney. Medullary and cortical blood perfusion increased by 84% and 95%, respectively, in W(UC) 30 min after unclipping (P < .001) but only with 8% and 9%, respectively, in W(UC+NS) (P = NS). Unclipping induced a marked increase in diuresis-natriuresis that was largely unaffected by ERNS. In W(UC) and W(UC+NS) BP returned to normotensive levels within 4 h. However, during the first 30 min, average BP decreased significantly less in W(UC+NS) (9%, 20 mm Hg) than in W(UC) (16%, 35 mm Hg) (P < .05). ERNS at 5 Hz effectively prevented the increase in medullary blood perfusion but did not affect the fall in blood pressure or the pressure diuretic/natriuretic response seen after unclipping. The results suggest that both the reduction in BP and the pressure-induced increase in diuresis/natriuresis seen when unclipping the 2K,1C renovascular hypertensive rat occurs largely independently of ERNS and an increase in medullary blood perfusion.

Animals↗

Driving forces for phase separation and partitioning in aqueous two-phase systems.

A set of simple analytical equations, derived from the Flory-Huggins theory, are used to identify the dominant driving forces for phase separation and solute (e.g., protein) partitioning, in the absence and presence of added electrolyte, in every general class of aqueous two-phase systems. The resulting model appears to capture the basic nature of two-phase systems and all trends observed experimentally. Case studies are used to identify fundamental differences in and the magnitudes of enthalpic and entropic contributions to partitioning in polymer-polymer (e.g., PEG-dextran), polymer-salt, and thermoseparating polymer-water (e.g., UCON-water) two-phase systems. The model therefore provides practitioners with a better understanding of partition systems, and industry with a simple, fundamental tool for selecting an appropriate two-phase system for a particular separation.

Chemistry Techniques, Analytical↗

Renal medullary blood flow and renal medullary antihypertensive mechanisms.

It has long been recognised that the kidneys take part in blood pressure control via both their exocrine and endocrine functions. An endocrine antihypertensive function of the renal medulla has been proposed. The renal medullary depressor substances ("medullipins"), are released in response to increased renal perfusion pressure. It has been suggested that the release of "medullipin" is controlled via changes in renal medullary blood flow. Recent observations also suggest that renal medullary blood flow is involved in the control of the pressure/natriuretic-diuretic action of the kidney. In this review we outline a unified hypothesis for blood pressure control via a combination of the plasma volume regulating pressure-natriuresis mechanism and the powerful antihypertensive actions of the "medullipins" (i.e. vasodilatation, inhibition of sympathetic drive and a diuretic action). It is hypothesised that the activity of both these systems are under control by renal medullary blood flow.

Animals↗

Temperature-induced phase partitioning of peptides in water solutions of ethylene oxide and propylene oxide random copolymers.

A thermoseparating random copolymer (Ucon 50-HB-5100) composed of (50%) ethylene oxide and (50%) propylene oxide has been used to form an aqueous two-phase system by heating the polymer-water solution above the cloud point of the copolymer. In the formed two-phase system a water rich top phase is in equilibrium with an aqueous polymer rich bottom phase. The partitioning of amino acids and peptides in this aqueous two-phase system has been studied. Hydrophobic peptides (containing aromatic amino acids) were strongly partitioned to the polymer rich phase, while hydrophilic peptides were enriched in the water rich phase. The effect of temperature on the partitioning was investigated and a decreased partitioning to the polymer rich phase was obtained upon temperature increase. The effect of two salts (NaClO4 and Na2SO4) on the partitioning of a positively charged polypeptide, poly(Lys, Trp), was very strong. With NaClO4 the polypeptide was quantitatively partitioned to the polymer rich phase while with Na2SO4 the polypeptide was partitioned to the water rich phase. Model calculations based on a modified Flory-Huggins theory have been performed to better understand the experimental behavior.

Epoxy Compounds↗

Effects of ions on partitioning of serum albumin and lysozyme in aqueous two-phase systems containing ethylene oxide/propylene oxide co-polymers.

Aqueous two-phase systems composed of ethylene oxide/propylene oxide random co-polymers, EO30/PO70 or Ucon (EO50/PO50), in the top phase and dextran T500 in the bottom phase, have been studied. The cloud point diagram for EO30/PO70 in water solution was determined. EO30/PO70 has a cloud point of 32 degrees C at a concentration of 10% (w/w). The phase diagram for the system EO30/PO70-dextran T500-water was determined. Salt effects have been studied on the partitioning of two model proteins, bovine serum albumin and hen egg white lysozyme, in EO30/PO70-dextran and Ucon-dextran systems. Ions with different hydrophobicity, i.e., with different position in the Hofmeister or lyotropic series, were investigated with reference to their effect on protein partition. The counterion hydrophobicity was shown to have a strong influence on the partitioning of BSA and lysozyme. Most extreme partitioning was obtained with hydrophobic (chaotropic) ions like CIO4- and I-. A comparison of protein partitioning between PEG-dextran and EO30/PO70-dextran has been done. A more extreme protein partitioning was obtained in the EO30/PO70-dextran containing system. Temperature-induced phase separation was studied with EO30/PO70 at 45 degrees C. Both BSA and lysozyme were completely partitioned to the water phase formed above the cloud point of EO30/PO70. Model calculations, based on Flory-Huggins theory of polymer solutions, have been done which could reproduce the salt effect on the protein partitioning in aqueous-two phase system.

Bromides↗

Effect of nitric oxide and renal nerves on renomedullary haemodynamics in SHR and Wistar rats, studied with laser Doppler technique.

The threshold for activation of the humoral renal antihypertensive system, presumably residing in the renomedullary interstitial cells (RIC), is substantially reset upwards in the spontaneously hypertensive rat (SHR). Depressor reactions, normally elicited by an increased renal perfusion pressure, can be inhibited either by high frequency renal nerve stimulation or blockade of nitric oxide synthesis, i.e. manoeuvres decreasing renal blood flow at this high perfusion pressure. The present study was designed to explore the effects on regional renal haemodynamics of blocking NO synthesis with N-omega-nitro-L-arginine (L-NNA) in chloralose anaesthetized SHR and Wistar rats. Mean arterial blood pressure (MAP), heart rate (HR), renal blood flow (RBF), cortical blood perfusion (CBP) and papillary blood perfusion (PBP) were measured in renally innervated and denervated SHR (Si n = 8, Sd n = 8) and in Wistar rats (Wi n = 10, Wd n = 10). An innervated non-treated Wistar group served as control (Ci n = 12). The laser Doppler technique was used to record CBP and PBP. MAP increased in all groups receiving L-NNA while HR, RBF and CBP simultaneously decreased. The relative decreases in RBF were more marked into the two SHR groups than in the corresponding Wistar groups. After L-NNA PBP also decreased in all four groups despite the increased MAP and more so in the Si group; Wi -19 +/- 8 (P < 0.05), Wd -17 +/- 6 (P = 0.07), Si -50 +/- 9 (P < 0.01) and Sd -25 +/- 9% (P < 0.05). We conclude that NO is important for maintaining PBP especially in SHR. The more marked decrease in PBP in the innervated SHR suggests a NO/renal nerve interaction in the control of renomedullary blood flow in SHR. This finding may be of importance for the regulation of the humoral renal depressor mechanism.

Animals↗

Treatment of closed tibial shaft fractures with unilateral external fixation.

Sixty-eight closed tibial shaft fractures were treated with an anterior unilateral external fixator over a 5 year period (1986-1991). Pin tract drainage and/or infection was seen in 71/380 pins. The total number of secondary operations, excluding planned pin extraction, during fracture healing was 61 (including 22 due to pin tract problems and 25 secondary corrections of alignment). Delayed union was seen in 14 fractures and non-union in three. Healing disturbances were more frequent following high-energy trauma. Bone grafting was done in 11 fractures. Eventually, all fractures healed within an average of 22 weeks. There were three refractures. At follow-up, on average 3 years after injury, functional results were excellent in 41 per cent, good in 46 and acceptable in 13 per cent. Due to the high number of unplanned secondary operations and prolonged healing times we do not consider the use of unilateral external fixation to be an adequate method for the treatment of closed tibial shaft fractures. The poor results are probably due to weight-bearing being too high in these patients relative to the mechanical stability provided by the external fixator system.

Adolescent↗

Renal and haemodynamic effects of nitric oxide blockade in a Wistar assay rat during high pressure cross-circulation of an isolated denervated kidney.

Blockade of NO synthesis with N-omega-nitro-L-arginine (L-NNA) inhibits the vasodepressor response seen in intact Wistar assay rats in which isolated kidneys perfused via an extracorporeal circuit are perfused at high pressure. This study explores the renal and haemodynamic changes associated with this inhibition. Isolated kidneys (IK) were perfused at high pressure (175 mmHg) by a pump in series with intact Wistar assay rats in which blood pressure (BP), haemodynamics and renal function were studied. Nitric oxide (NO) synthesis was blocked by L-NNA (2.5 mg kg-1) in 13 experiments (175NO) while 14 control experiments (175C) were performed. IK was perfused at 90 mmHg in seven experiments (90C). The BP drop in the 175C assay rat was blocked by L-NNA in 175NO (P < 0.01). However, when the blockade was reversed with L-arginine infusion (20 mg kg-1 min-1) BP declined also in 175NO. Effective renal plasma flow (ERPF) and glomerular filtration rate (GFR) fell dramatically after L-NNA in both the assay rat and in IK despite a high perfusion pressure. The marked increase in filtration fraction (FF) after L-NNA suggests a dominating postglomerular vasoconstriction. The natriuretic response in IK to 175 mmHg was also markedly blunted by L-NNA. We conclude that NO blockade inhibits the renomedullary depressor mechanism probably by restricting renal blood flow, and also blunts the pressure induced natriuretic response as a result of a reduced sodium filtration. Finally, the autoregulation of whole kidney blood flow seems to be more efficient although set at a higher level of vasoconstriction.

Animals↗

Efferent renal sympathetic nerve stimulation in vivo. Effects on regional renal haemodynamics in the Wistar rat, studied by laser-Doppler technique.

Intrarenal blood flow regulation probably affects long-term blood pressure homeostasis. We have previously shown that 5 Hz renal sympathetic stimulation inhibits a humoral renal depressor mechanism, otherwise activated when increasing perfusion pressure to an isolated kidney in a cross-circulation set-up. This inhibition was suggested to occur as a result of a reduction of renomedullary blood flow. Little is known about nervous blood flow regulation within the medulla. Therefore in this study, total renal (RBF), cortical (CBF) and papillary (PBF) blood flows were separately measured by ultrasonic and laser-Doppler techniques in Wistar rats during graded renal sympathetic stimulations. Periods of 15 min stimulation at 0.5, 2 and 5 Hz were performed in random order. RBF decreased at 0.5 Hz by 1%, at 2 Hz by 16% (P < 0.001) and at 5 Hz by 49% (P < 0.001). In a similar fashion (r = 0.73, P < 0.001), CBF decreased by 1%, 10% (P < 0.001) and 37% (P < 0.001), respectively. By contrast, PBF increased by 2% at 0.5 Hz and 4% at 2 Hz, while it decreased at 5 Hz, by 4% (P < 0.05, compared with 2 Hz). It seems therefore, that superficial renocortical and total renal blood flows are closely regulated by renal sympathetic nerves with increasing vasoconstriction at higher frequencies, while medullary blood flow, on the other hand, seems to be under strong local control, tending to offset neurogenic flow restrictions.

Animals↗

Efferent renal nerve stimulation inhibits the antihypertensive function of the rat renal medulla when studied in a cross-circulation model.

The aim of this study was to investigate the effects of renal nerve stimulation on the humoral renal antihypertensive system. An isolated kidney (IK) was perfused at normal or high arterial pressures from a normotensive assay rat by means of a perfusion pump. Perfusion pressure (PP) to the IK was 90 mmHg for a control period of 30 min. In three of five experimental groups PP was then increased to 175 mmHg. In two of the groups the renal nerves were stimulated at 2 (P-175(2Hz)) or 5 Hz (P-175(5Hz)) for 60 min. The remaining group served as a control (P-175C). In two groups IK pressure was maintained at 90 mmHg with 5 Hz nerve stimulation (P-90(5Hz) or without nerve stimulation (P-90C). MAP of the assay rat decreased by 22 and 27% (P < 0.001) in the P-175C and P-175(2Hz) groups, respectively during the 60 min period of nerve stimulation, but remained stable in P-175(5Hz). Renal blood flow increased in the IK when PP was increased in P-175C, but did not change significantly in P-175(2Hz) or P-175(5Hz). Blood pressure remained constant in the assay rat when the IK was perfused at 90 mmHg. The renal excretory functions of the IK decreased in a frequency dependent manner by 2 and 5 Hz renal nerve stimulation compared with P-175C. We conclude that 5 Hz renal nerve stimulation inhibits the pressure dependent release of humoral depressor substances from an IK perfused at 175 mmHg, whereas this is not seen when stimulating at 2 Hz. It is suggested that hte release of antihypertensive substances from the renal medulla requires an increased renomedullary blood flow.

Animals↗

Spinal canal remodelling after stabilization of thoracolumbar burst fractures.

Spinal canal areas were measured prospectively in 22 consecutive burst fractures of the thoracolumbar junction, preoperatively, within 1 week postoperatively and 1 year after operation. Preoperative canal encroachment averaged 38% (range 10%-70%) of the estimated original area. The 11 patients with neurological impairment had a significantly more severe initial canal encroachment (mean 48%) than those who were neurologically intact (mean 33%). Postoperatively, canal encroachment had decreased to a mean of 18% (range 0%-62%). Within 12 to 15 months postoperatively, canal encroachment was further reduced by resorption of bone fragments to a mean of 2%. The largest observed remaining encroachment was 29%. The amount of bone resorption correlated significantly with the persistent postoperative encroachment. A critical appraisal of the methods used to assess the pre-fracture canal area revealed that reconstructing the vertebral foramen of the fractured vertebra on CT scans substantially overrated the original area as compared with averaging the canal area of the two adjacent vertebrae.

Adult↗

Surgery of cervical spine metastases: a retrospective study.

Fifty-one consecutive patients with metastatic lesions of the cervical spine were treated surgically. The most common primary tumor types were breast cancer and myeloma. In 14 (27%) patients, the cervical lesion was the first manifestation of the malignancy. All patients suffered from severe pain but only six had long tract symptoms. Five tetraparetic patients were confined to bed. Vertebral body collapse occurred in 73% of cases. The surgical technique was individualized according to the patient's general condition, the site of metastasis on the vertebra, and the level and number of levels bearing in mind that the treatment is palliative in nature. The goal of treatment was a better quality of life. In the upper cervical spine the technique described by Sjöström et al. was used, if technically possible. If the odontoid process had been totally destroyed, an occipitocervical stabilization was chosen. In the lower cervical spine, an anterior approach was used to resect the tumor growth. Anterior support was provided with bone cement if the patient was not expected to survive long; otherwise bone grafting was used. In cases with two or more levels of involvement, a combined anteroposterior stabilization was usually performed. Good pain relief was achieved postoperatively. The operation was generally well-tolerated by the patients, mild dysphagia being the most common complaint. One patient died 2 days postoperatively of heart failure, giving a postoperative mortality of 2%. Rhizopathy symptoms were relieved totally in 15 patients and partially in 6.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

CT analysis of pedicles and screw tracts after implant removal in thoracolumbar fractures.

Twenty-one burst fractures of the thoracolumbar junction were stabilized with a transpedicular fixator by surgeons experienced in this technique. Screws 5 or 6 mm in diameter were used. After the removal of the device 1 year postsurgery, axial CT scans were obtained of the instrumented vertebrae. Eighty-two pedicles were examined. In 16 pedicles, medial or lateral cortical defects were found. Five screws had intruded into the spinal canal by a maximum of 3.5 mm. In 48 pedicles a correlative comparison with the preoperative examinations was possible. Compared with the dimensions of the pedicles on the preoperative CT scans, 31 had increased in width, and 14 showed deformation indicative of fractures of the lateral pedicle wall. When the screw diameter exceeded 65% of the pedicles' outer diameter, 85% of the pedicles expanded. One of four screws had penetrated the anterior wall of the vertebra. Pedicle screw penetration on the left side above L2 poses potential risk of erosion of the aorta. The use of pedicle screws at the thoracolumbar junction by experienced surgeons carries some risk for malplacement and neurological damage. Mismatch between pedicle dimension and screw size results in pedicle expansion and lateral wall fractures, probably during screw insertion. Preoperative CT examinations should be used to help in choosing appropriate screw diameter presurgery.

Adult↗

Direct leg lengthening.

Twenty patients with an average posttraumatic leg length shortening of 4.6 cm (range 2.5-9) underwent direct leg lengthening. The operation time averaged 210 min and the peroperative blood loss was 1,800 ml. Angular and rotational malalignment, when present, were corrected. Lengthening averaged 3 cm. At follow-up, two patients had serious sequelae after vascular injuries. Seven patients had postoperative neurological complications, which in four cases resolved completely. The time required for solid union of the lengthened segment averaged 10 months. Bone grafting two or more times was performed in six patients. Seventeen patients were assessed an average of 7 years (range 3-10) after surgery. Thirteen of these were satisfied with the results of the lengthening. Complications of the procedure and/or a remaining major leg length inequality could explain the dissatisfaction of the others. A majority of the patients complained of low-back pain both preoperatively and at follow-up. Few complaints about the joints in the long leg were expressed. Preoperative pain about the hip and knee in the short leg existed in more than half of the patients, and these complaints were reduced on a weak statistical level at follow-up. Walking ability improved in 12 patients, working ability in 10, and recreational activity level in eight. Direct leg lengthening is generally regarded as major, demanding surgery, entailing potential risks of serious complications, and should be used with great care and only in selected cases.

Adolescent↗

Surgical treatment of vertebral metastases.

Metastatic tumors often spread to the vertebral column. When the mechanical strength of a vertebra is decreased as a result of tumor-induced bone destruction, a pathologic fracture may occur. Such a fracture is often associated with severe pain. If it occurs in the thoracic or upper lumbar region, there is a major risk of paraplegia if the fractured vertebral body is displaced into the spinal canal. Metastases in the vertebral column also can cause neurologic symptoms due to direct infiltration of the tumor into the spinal canal. Due to recent advances in spinal surgery, effective help often can be provided to these patients. The extent and type of surgical intervention, however, must be carefully considered in each individual case.

Fracture Fixation, Internal↗