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Biomedical subjects

J Møller-Petersen

Publications and source records attributed to J Møller-Petersen.

At least 37 records · Page 2Linked to original sources
PubMed1989

Serum creatine kinase-B activity in patients with chronic lower-limb ischemia and after leg amputation.

Serum creatine kinase-B (CK-B) activity was measured and electrocardiograms (ECG) recorded before and after operation in two groups of ten orthopedic patients. Group I underwent lower-limb amputation because of severe, chronic ischemia of the leg and group II (controls) had knee prosthesis implantation or knee ligament surgery. In group I the number of patients with CK-B activities exceeding the discrimination value (0.25 muka-tal/l) for acute myocardial infarction preoperatively and 2, 24, 48, 72 hours, and at 7 days postoperatively were, respectively, three, three, five, three, two and nil. In Group II the serum CK-B activity remained below the myocardial infarction discrimination value in all patients at all times. No ECG abnormalities indicating myocardial infarction appeared in any patient of either group. The study indicates that severe, chronic lower-limb ischemia and amputation of the leg may cause elevation of non-cardiac CK-B activity in serum that can interfere with enzymatic recognition of acute myocardial infarction.

Adult↗
PubMed1988

Renal handling of cathodic trypsin-like immunoreactivity in man.

The renal handling of cathodic trypsin-like immunoreactivity (TLI) was examined in 60 healthy persons (group I), 59 patients with proteinuria (group II), 7 healthy men receiving intravenous lysine to partially inhibit renal tubular protein reabsorption (group III) and 20 patients who underwent diagnostic renal vein catheterization (group IV). The urinary TLI concentration and TLI ratio (TLI clearance divided with creatinine clearance) were higher in group II than group I (p less than 0.001, Mann-Whitney test). In group II negative correlations were present between serum TLI and creatinine clearance (Spearman's rho = -0.84, p less than 0.001) and between TLI ratio and creatinine clearance (rho = -0.76, p less than 0.001). In group III the renal TLI clearance was undetectable before lysine but increased to a maximal median value of 4.00 ml/min per 1.73 m2 (range: 2.44-9.25 ml/min per 1.73 m2) after lysine. In group IV, the renal arterio-venous extraction of TLI was correlated to inulin extraction (rho = 0.85, p less than 0.001). The glomerular filtrability (the ratio between TLI and inulin extractions) was median 0.53 (range: 0.13-0.94). In conclusion, TLI has a high glomerular filtration and an almost complete tubular reabsorption and catabolism (with normal kidney function).

Adult↗
PubMed1988

Rhabdomyolysis and acute renal failure following an overdose of doxepine and nitrazepam.

A 50-year-old woman developed rhabdomyolysis and myoglobinuric renal impairment after an oral dose of 250 mg nitrazepam and 1,250 mg doxepin. Serum creatinine increased from 70 mumol/l to 472 mumol/l in two days. Serum creatine phosphokinase reached a maximal level of 391 mu kat/l (reference range less than 2.5 mu kat/l) on the third day and serum myoglobin was maximally 910 nmol/l (reference range less than 4.5 nmol/l) on the fourth day after the overdose. Passive and active movements of the knees and ankles became increasingly restricted, but the patient felt no muscle pain. Diuresis decreased to 20-22 ml/hour in spite of repetitive doses of furosemide, but was enforced to greater than 100 ml/hour by vigorous infusion of saline. Haemodialysis was avoided on this regimen. It is suggested that in patients intoxicated with nitrazepam and/or doxepin, rhabdomyolysis should be suspected when a rapidly increasing serum concentration of creatinine is found, even in the absence of muscle pain.

Acute Kidney Injury↗
PubMed1988

Cyclical changes in endogenous overnight creatinine clearance during the third trimester of pregnancy.

To investigate the pattern of change in endogenous overnight creatinine clearance during the third trimester, 12 healthy women with uncomplicated pregnancies were examined three times a week. Urine was collected overnight from 22.00 to 08.00 hours and analysed for creatinine. Serum was sampled in the morning and analysed for creatinine, beta 2-microglobulin, progesterone and estradiol. The general trend of creatinine clearance was parabolic with a declining level during the last month before term. A sinusoid pattern with minimum values around the time when the women would have had menstruation had they not become pregnant was superimposed on the parabolic trend. A mathematical model (parabolas overlaid with a cosine curve) was constructed and fitted to the data. The cyclical pattern was significant. Serum creatinine showed a pattern with increasing values during the last 4-6 weeks before term and cyclical changes which were also significant. In the individual case the monthly and preterm clearance decrement sometimes was over 50%. Monthly and preterm decreases in creatinine clearance may be quite normal and serial measurements of creatinine clearance are therefore necessary to determine if declining values indicate pathological falls in the glomerular filtration rate.

Adult↗
PubMed1988

Serum cathodic trypsin-like immunoreactivity, pancreatic lipase, and pancreatic isoamylase as diagnostic tests of chronic pancreatitis or pancreatic steatorrhea.

We compared serum concentrations of cathodic trypsin-like immunoreactivity, pancreatic lipase, and pancreatic isoamylase as diagnostic tests of chronic pancreatitis (and of pancreatic steatorrhea in the 41 patients with steatorrhea) in 105 patients (57 men, 48 women) consecutively investigated because of clinical suspicion of chronic pancreatitis. Chronic pancreatitis (36 patients), pancreatic steatorrhea (24 patients), and other diseases were diagnosed without knowledge of the serum levels of the three enzymes. When evaluated by means of receiver operating characteristic curves, no differences were found in diagnostic performance of the enzymes with regard to chronic pancreatitis or pancreatic steatorrhea. The sensitivity and specificity for recognition of chronic pancreatitis ranged from 0.306 to 0.444 and from 0.942 to 0.986 when the discrimination values were chosen to give highest efficiencies. The similar ranges for pancreatic steatorrhea were 0.500-0.708 and 0.882-0.941. In conclusion, none of the three enzymes had any advantage over the others as diagnostic tests of chronic pancreatitis or of pancreatic steatorrhea. Only positive test results have clinical importance because of the low sensitivities of the three enzymes.

Adult↗
PubMed1987

Myoglobin and creatine phosphokinase in serum during and after aortic bypass grafting.

In 10 patients undergoing aortic bypass grafting with peroperative aortic cross-clamping we measured the levels of myoglobin and creatine phosphokinase. The duration of peroperative lower limb arterial clamping ranged from 50 min to 95 min. No significant increase in either serum myoglobin or in serum creatine phosphokinase was found during lower limb arterial clamping or for the first two hours after release of ischemia. Both parameters reached a maximum value at 24 hours after release of ischemia, with a median serum myoglobin concentration of 565 micrograms/l (range: 132-2688 micrograms/l) and a median serum creatine phosphokinase activity of 457 U/l (range: 190-1602 U/l). The increase in serum myoglobin and creatine phosphokinase was not associated with the duration of lower limb arterial clamping. Renal impairment was not found in these patients, as evaluated by the serum concentration of beta 2-microglobulin.

Aged↗
PubMed1987

Endogenous overnight creatinine clearance, serum beta 2-microglobulin and serum water during the menstrual cycle.

Endogenous overnight (22.00-08.00 hours) creatinine clearance and serum concentrations of beta 2-microglobulin and water were measured three times a week during 11 ovulatory menstrual cycles. In some of the women creatinine clearance changed more than 100% within a week from values below reference range to high normal levels. In all the women the creatinine clearance was higher during the luteal than during the follicular phase and correlated with the production of ovarian hormones. The urinary excretion rate of creatinine was highest during the luteal phase. Urinary volume, serum creatinine and serum water were not significantly influenced by the menstrual phases. An unexplained finding was a parallel change in the individual creatinine clearance and serum beta 2-microglobulin during the luteal, but not during the follicular phase. Our results suggest that ovarian hormones influence creatinine clearance during the menstrual cycle. One must therefore accept even considerable short-time variations in creatinine clearance in fertile women. It remains to be settled if these changes reflect true alterations in glomerular filtration rate or mainly changes in the urinary (tubular) excretion rate of creatinine.

Adult↗
PubMed1987

Endogenous overnight creatinine clearance compared with 51Cr-EDTA clearance during the menstrual cycle.

Fourteen healthy women aged 21-41 years, who did not take oral contraceptives and who all had ovulatory cycles, were examined once in the follicular phase and once in the luteal phase of a single menstrual cycle. The glomerular filtration rate (51Cr-EDTA clearance) increased from the follicular to the luteal phase by a median of 7.0% (95% confidence interval: 0.7-10.3%). Endogenous overnight (22.00-08.00 hours) creatinine clearance increased by a median of 7.3% (95% confidence interval: 1.0-14.6%). The urinary creatinine excretion rate also increased with a median of 7.3% (95% confidence interval: 1.5-11.9%) whereas the serum concentrations of creatinine and beta 2-microglobulin, urine flow and urinary excretion rate of urea did not change. The results confirm previous observations of an increase in creatinine clearance in the luteal phase of the menstrual cycle and indicate that the increase in overnight creatinine clearance reflects a true change in glomerular filtration rate.

Adult↗
PubMed1987

Evaluation of the usefulness of enzymatic diagnosis of myocardial infarction in patients with acute arterial occlusion of the lower extremities.

The serum activities of aspartate aminotransferase, lactate dehydrogenase, creatine kinase and estimated creatine kinase isoenzyme MB (CK-B) were investigated in 12 patients before and after revascularization of ischaemic lower extremities. All patients suffered from sudden lower limb arterial occlusion and underwent embolectomy through a small arteriotomy in the groin. The median serum activity of all four enzymes was elevated before surgery and further increased during the first 24-48 h after revascularization. Median serum activity of aspartate aminotransferase, creatine kinase and lactate dehydrogenase were continuously elevated 7 days after the operation. A high relative CK-B activity coincided in one patient with the development of electrocardiographic evidence of acute myocardial infarction. It is concluded that any of these four enzymes should be used with caution in the diagnosis of acute myocardial infarction before, during or after operation in patients who have sustained prolonged ischaemia of the lower extremities.

Acute Disease↗
PubMed1987

Hypermyoglobinemia after successful arterial embolectomy.

Myoglobin concentrations in serum and urine were measured in eight patients who underwent successful arterial embolectomy in the femoral or iliac arteries. Median serum myoglobin levels significantly increased after revascularization to a maximum of 4741 micrograms/L (reference range: 0 to 80 micrograms/L) 2 hours postoperatively, with a concomitant and correlated increase in the urine myoglobin concentration. Three days after the operation, serum myoglobin concentrations were still substantially elevated in three patients. None of our patients suffered permanent renal damage, but transient renal impairment was noted in five patients, as evaluated from the serum and urine beta 2-microglobulin concentrations. We found an association between the concentrations of myoglobin in serum and urine (Spearman's rho: 0.66; p less than 0.001) and between the concentrations of myoglobin in urine and beta 2-microglobulin in urine (Spearman's rho: 0.65; p less than 0.001). Our results indicate a transient renal impairment associated with hypermyoglobinemia and myoglobinuria, even after successful arterial embolectomy.

Aged↗
PubMed1987

Renal haemodynamics and extracellular homeostasis during the menstrual cycle.

Renal haemodynamics and extracellular homeostasis during the menstrual cycle were studied in 14 healthy women (age 21-41 years) who were not taking oral contraceptives in the follicular (Period I) and luteal phase (Period II). The glomerular filtration rate [( 51Cr] EDTA clearance) and the effective renal plasma flow ([125I] hippuran clearance) increased from Period I to II by a median of 6.3% (95% confidence interval (CI): 0.6-9.2%) and 7.3% (95% CI: -0.4-22%) respectively. Serum sodium decreased from period I to II (p less than 0.01) by a median of 1 mmol/l (95% CI: -2.0 to -0.5 mmol/l) and the urinary excretion rate of potassium increased (p less than 0.02) from a median value of 35 mumol/min in Period I to 45 mumol/min in Period II. The extracellular fluid volume did not change between the two periods but the concentration of water in serum increased (p less than 0.05) from a median value of 91.7-92.0 g/100 g in Period II. Serum total protein and serum albumin both showed a borderline statistically significant decrease from Period I to II. The investigation demonstrated a number of physiological and biochemical changes from the follicular to the luteal phase, most of which in a lower scale mimic well known changes that occur during pregnancy.

Adult↗
PubMed1986

Evaluation and comparison of cathodic trypsin-like immunoreactivity, pancreatic lipase and pancreatic isoamylase in the diagnosis of acute pancreatitis in 849 consecutive patients with acute abdominal pain.

In 849 patients (417 men, 432 women) consecutively hospitalized with acute abdominal pain we compared the value of serum cathodic trypsin-like immunoreactivity, pancreatic lipase (EC 3.2.1.3) and pancreatic isoamylase (EC 3.2.1.1) as diagnostic tests for acute pancreatitis. The diagnoses of acute pancreatitis (in 49 patients, 5.8%) and other diseases were made without knowledge of these enzyme values. When evaluated by means of receiver operating characteristic curves no differences were found in diagnostic performance of the three enzymes. Use of combinations of different enzymes had no advantage over single enzyme determination using discrimination analysis for evaluation. The highest efficiency was for all three enzymes 0.991 (95% confidence limits: 0.983-0.995) and for all three enzymes the discrimination value giving this efficiency was several times the upper limit of reference range: 1 779 micrograms/l for cathodic trypsin-like immunoreactivity, 831 U/l for pancreatic isoamylase and 316 micrograms/l for pancreatic lipase. None of the enzymes had any prognostic value at admission in predicting a mild or severe attack of acute pancreatitis. In conclusion, no single enzyme or combination of enzymes had any diagnostic advantage for acute pancreatitis in patients with acute abdominal pain. Thus selection of one of the three enzymes as diagnostic test of acute pancreatitis is to be based on considerations such as economy, methodological simplicity, possibility of automated assay and the time-consumption at the assay.

Abdomen↗