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Biomedical subjects

K Lindquist

Publications and source records attributed to K Lindquist.

At least 19 recordsLinked to original sources
PubMed2006

Endogenous sex hormone levels and risk of cognitive decline in an older biracial cohort.

BACKGROUND: Older women treated with conjugated estrogens may have an increased risk of dementia, but the effect of naturally occurring sex hormones on cognition is not certain. METHODS: Bioavailable estradiol and free testosterone level were obtained from 792 (55% men, 51% black) participants. We assessed cognition with the Modified Mini-Mental State Examination (3MS), Selective Reminding Test (SRT) and CLOX 1 at baseline and 2 years later. RESULTS: Women in the lowest estradiol tertile were more likely than those in the highest tertile to decline (> or = 1.0 S.D. of change) on 3MS (25% versus 9%, adjusted odds ratio [OR] = 3.9; 95% confidence interval [CI] = 1.6-9.6) and on SRT (28% versus 12%, adjusted OR [95% CI] = 3.3 [1.4-7.9]) but not CLOX 1. There was a borderline association between low estradiol tertile and decline on SRT in men (22% versus 14%, adjusted OR [95% CI] = 1.9 [0.9-3.9]). Testosterone level was not associated with decline in cognition in either men or women. Findings did not differ by race. CONCLUSIONS: Older women with low estradiol levels were more likely to experience decline in global cognitive function and verbal memory, and a similar trend was observed for verbal memory in men. This supports the hypothesis that endogenous sex hormones may play an important role in the maintenance of cognitive function in older adults.

Age Distribution↗
PubMed2006

PPAR-gamma Pro12Ala genotype and risk of cognitive decline in elders.

BACKGROUND: The Pro12Ala polymorphism of peroxisome proliferator-activated receptor-gamma (PPAR-gamma) has been associated with decreased risk of diabetes and obesity, both disorders linked to cognitive impairment. We tested whether this polymorphism is associated with cognition. METHODS: Two thousand nine hundred sixty-one participants (mean age, 74.1; 41% Black; 52% women) were administered the Modified Mini-Mental State Examination (3MS) and Digit Symbol Substitution Test (DSST) at baseline and 4 year follow-up. Test scores were adjusted for age, sex, education, cerebrovascular disease, depression and APOE genotype and additionally for race. We determined the association between Ala allele and development of cognitive decline (3MS decline of > or = 5 points). RESULTS: At baseline, unadjusted scores on both cognitive tests were higher for Ala carriers compared to non-carriers (3MS, 94.2 versus 92.5, p<0.001; DSST, 40.2 versus 34.5, p<0.001). Similarly, follow-up scores were higher for Ala carriers. Multivariable adjustment led to similar results; additional adjustment for race attenuated the baseline 3MS results. After 4 years, 17.5% of Ala carriers developed cognitive decline compared to 25% among non-carriers (unadjusted OR=0.61; 95%CI, 0.46-0.82; adjusted OR=0.75; 95%CI, 0.55-1.02). Further adjustment for metabolic variables including fasting blood glucose and lipid level did not change the results. CONCLUSIONS: The PPAR-gamma Ala12 allele carriers may have less risk of developing cognitive decline.

Aged↗
PubMed2003

Inflammatory markers and cognition in well-functioning African-American and white elders.

BACKGROUND: Several lines of evidence suggest that inflammatory mechanisms contribute to AD. OBJECTIVE: To examine whether several markers of inflammation are associated with cognitive decline in African-American and white well-functioning elders. METHODS: The authors studied 3,031 African-American and white men and women (mean age 74 years) enrolled in the Health, Aging, and Body Composition Study. Serum levels of interleukin-6 (IL-6) and C-reactive protein (CRP) and plasma levels of tumor necrosis factor-alpha (TNFalpha) were measured at baseline; cognition was assessed with the Modified Mini-Mental State Examination (3MS) at baseline and at follow-up. Cognitive decline was defined as a decline of >5 points. RESULTS: In age-adjusted analyses, participants in the highest tertile of IL-6 or CRP performed nearly 2 points lower (worse) on baseline and follow-up 3MS (p < 0.001 for all) and declined by almost 1 point over the >2 years (p = 0.01 for IL-6 and p = 0.04 for CRP) compared with those in the lowest tertile. After multivariate adjustment, 3MS scores among participants in the highest tertile of IL-6 and CRP were similar at baseline but remained significantly lower at follow-up (p < or = 0.05 for both). Those in the highest inflammatory marker tertile were also more likely to have cognitive decline compared with the lowest tertile for IL-6 (26 vs 20%; age-adjusted odds ratio [OR] = 1.34; 95% CI 1.06 to 1.69) and for CRP (24 vs 19%; OR = 1.41; 95% CI 1.10 to 1.79) but not for TNFalpha (23 vs 21%; OR = 1.12; 95% CI 0.88 to 1.43). There was no significant interaction between race and inflammatory marker or between nonsteroidal anti-inflammatory drug use and inflammatory marker on cognition. CONCLUSIONS: Serum markers of inflammation, especially IL-6 and CRP, are prospectively associated with cognitive decline in well-functioning elders. These findings support the hypothesis that inflammation contributes to cognitive decline in the elderly.

Black or African American↗
PubMed2000

A study of plasma immunoglobulins profile in connection with restorative proctocolectomy.

BACKGROUND: Restorative proctocolectomy is an operative procedure that in principle means proctocolectomy, preserving the anal sphincters and construction of an ileal pouch which is sutured to the dentate line. The method is used mostly in case of surgical treatment of ulcerative colitis or familial polyposis coli. The procedure means different manipulations with the distal ileum that may influence the function of gut-associated lymphoid tissues, a major subdivision of the immune system. AIM: The aim of the present investigation was to study the plasma concentration of immunoglobulins in connection with the restorative proctocolectomy operation. METHODS: Forty five patients received an ileoanal pouch (IAP) because of ulcerative colitis. Twenty seven patients were males and 18 females. The mean age was 34 (range 18-55) years. Twenty six patients were first operated on emergency by subtotal colectomy with terminal ileostomy. In a second operation, the rectum was excised and an ileoanal pouch and a loop ileostomy that diverted the bowel content from the distal ileum was performed. Eighteen elective patients had their colectomy performed at the same time as the pouch operation. As a last procedure the diverting loop ileostomy was closed and thereby the distal ileum and the ileoanal pouch was put into function. Blood samples for plasma immunoglobulin analyses was collected from the patients before the colectomy, after colectomy with terminal ileostomy before construction of the pouch, during the period with pouches prior to loop ileostomy closure and 12 months after its closure. Immunoglobulins in plasma were determined by nephelometry method. The data was analyzed statistically by ANOVA and linear regression analysis. RESULTS: There was a significant difference preoperatively, in plasma immunoglobulin G (P-IgG) between the patients who were operated on electively compared to the emergency patients (p < 0.03). This was the only significant difference between values for the emergency and elective groups throughout the study. In the emergency patients after colectomy and with terminal ileostomy plasma immunoglobulin A (P-IgA) and immunoglobulin A (P-IgM) concentrations in plasma had increased significantly compared to preoperative (p < 0.03) and (p < 0.002) respectively. During the time with loop ileostomy plasma IgM was still found to be significantly elevated (p < 0.02) compared to the level before colectomy. In the electively operated patients plasma IgA and IgM were significantly increased after colectomy and pouch construction during the time with loop ileostomy compared to preoperatively (p < 0.04) and (p < 0.0004). After 12 months with functional pouches the plasma immunoglobulins in both groups were similar to the elective patients preoperatively. CONCLUSION: The immunoglobulins IgG, IgA and IgM were studied in connection with restorative proctocolectomy. Preoperatively, IgG was found to be significantly lower in emergency compared to elective patients. The difference is probably due to increased losses and impaired production of IgG in the acute phase of ulcerative colitis. IgA and IgM were found to increase significantly after colectomy and construction of an ileostomy but how these measures were responsible for the changes could not be determined in the present study. Twelve months after loop ileostomy closure there were no longer any significant changes of the immunoglobulins compared to elective patients with ulcerative colitis preoperatively.

Adolescent↗
PubMed2000

Observations in the blood lipid profile in patients undergoing restorative proctocolectomy.

BACKGROUND: Ileal dysfunction, and resection or exclusion may affect intestinal bile acid resorption resulting in alterations in serum lipid concentration. In restorative proctocolectomy, the different procedures may involve the ileum in all three ways. AIM: The aim of the present study was to analyse possible changes of the blood lipid profile during the different steps of restorative proctocolectomy operative procedure. METHOD: There were nineteen elective patients on their ordinary diet and 19 emergency patients on total parenteral nutrition. The former group were primarily operated on with colectomy; ileoanal pouch and loop ileostomy while the later group had had an emergency colectomy and terminal ileostomy before the pouch operation. Thirty five of the patients had ulcerative colitis, 2 had familial colon polyposis and 1 familial cancer syndrome. Blood specimens were collected in the mornings with the patients in a fasting state. The emergency patients were on unchanged ordinary diet during the preoperative period. Serum cholesterol and triglyceride were determined by enzymatic methods. Lipoproteins, studied only in the elective patients, were analysed by a combination of ultracentrifugation and precipitation. Student's t-test with Bonferroni's correction for multiple comparisons was used for statistic calculations. RESULTS: Preoperatively, the emergency group had significantly lower serum cholesterol but not serum triglycerides values compared to the elective group. This finding is probably due to difference in the preoperative nutrition. The cholesterol levels among patients who received steroids in the two groups were compared and found to be significantly lower in the emergency group. Later, no significant differences concerning cholesterol and triglycerides were found between the groups. The cholesterol level was not significantly different in the elective group between patients who receive hydrocortisone and those who did not. During the period with loop ileostomy cholesterol was significantly lowered while the triglycerides were significantly increased compared to the preoperative values of the elective group. The decrease of serum cholesterol levels was correlated to the length of the excluded ileum. During the same period alpha-lipoprotein decreased significantly and reached values below the normal of the reference material. Beta-lipoproteins, which were subnormal already preoperatively, increased but not significantly. Pre-beta-lipoproteins were at the same level at all stations. At 12 months with functioning pouches all analysed values, with the exception of beta-lipoproteins. were within the normal limits set by the reference material. In the emergency group the patterns for triglycerides and cholesterol were similar but for the preoperatively depressed cholesterol values. After 12 months with functioning pouch the serum cholesterol and triglycerides were at the same level as for the elective patients. CONCLUSION: A serum lipid profile was studied in patients undergoing restorative proctocolectomy. Serum cholesterol and alpha-lipoprotein decreased and triglycerides increased when the patients had a diverting loop ileostomy. At 12 months after it's closure and with a functioning pouch, the patients had the same profile as the elective patients preoperatively, and with exception of beta-lipoproteins within normal limits in spite of the loss of the colon and the construction of a pouch of the distal ileum.

Adolescent↗
PubMed1999

Effect of restorative proctocolectomy on gastric acid secretion and serum gastrin levels: a prospective study.

PURPOSE: The aim of the present study was to analyze gastric acid secretion after restorative proctocolectomy, because it has been shown that ileal resection or exclusion may increase gastric acid secretion. An increased output of gastric acids may decrease the intestinal passage time and contribute to looser stools. METHODS: Eleven patients who had elective colectomy and ileoanal pouch because of ulcerative colitis were investigated. Eight patient were males. Eight S-pouches and three J-pouches were constructed. Gastric acid secretion (retention, basic, and stimulated) was studied, together with serum gastrin, pentagastrin, and pepsinogen, in patients before colectomy and after having had the pelvic pouch functioning for 12 months. RESULTS: A significant increase, compared with preoperative levels, in retention, basic, and stimulated gastric acid secretion was found after 12 months with the pouch functioning. Levels of serum gastrin, pentagastrin, and pepsinogen were unchanged. CONCLUSION: Restorative proctocolectomy leads to a significant increase in gastric acid secretion. These findings may be of importance with regard to intestinal passage time and consistency of the stools.

Adult↗
PubMed1995

Long-term histomorphological surveillance of the pelvic ileal pouch: dysplasia develops in a subgroup of patients.

BACKGROUND & AIMS: Little is known about the long-term morphology of the pelvic ileal pouch after restorative proctocolectomy in patients with ulcerative colitis. This study analyzed the mucosal adaptation in the pouch during a long-term follow-up. METHODS: Mucosal biopsy specimens were obtained from 87 patients during a follow-up of 6.3 years (SD, 2.7; range, 3-14 years). The villous surface density, degree of inflammation, and type of mucin were determined from glycolmethacrylate-embedded sections. RESULTS: Three basic patterns of mucosal adaptation were observed: regular response with normal mucosa or mild villous atrophy and no or mild inflammation (type A, 51%), transient atrophy response with temporary moderate or severe villous atrophy followed by normalization of architecture (type B, 40%), and constant atrophy response with permanent subtotal or total villous atrophy developing from the early functioning period accompanied by severe pouchitis (type C, 9%). Low-grade dysplasia occurred in 3 patients with type C response. CONCLUSIONS: In a small group of patients with ulcerative colitis, the mucosa of the pelvic pouch adapts with constant severe villous atrophy accompanied by long-standing pouchitis. This group of patients should be identified and undergo regular endoscopic and histomorphological surveillance because of risk of developing neoplasia in the pouch mucosa.

Adult↗
PubMed1995

Comparing interspersed requests and social comments as antecedents for increasing student compliance.

Two students were alternately presented with interspersed high-compliance requests and social comments as antecedents to low-compliance requests. An initial comparison demonstrated similar positive effects on compliance for interspersed requests and social comments. A second analysis indicated that the effectiveness of social comments for increasing compliance was related to the time interval between social comments and low-compliance requests.

Journal Article↗
PubMed1995

Pelvic pouch-anal anastomoses: pros and cons about omission of mucosectomy and loop ileostomy. A study of 60 patients.

Pelvic pouches were constructed in 60 consecutive patients from 1987 to 1991. The first 30 patients underwent mucosectomy and construction of handsewn reservoirs, and ileoanal anastomoses protected by loop ileostomy (group A). In the following 12 patients (group B1) J pouches and ileoanal anastomoses were constructed by total stapling technique without mucosectomy, with a loop ileostomy. In the last 18 patients the loop ileostomy was omitted (group B2). A comparison between group A and B and between group B1 and B2 was made concerning anaesthesia time, hospital stay, blood transfusions, postoperative complications and pouch function at 2 and 12 months. It was found that the stapling technique (group B) reduced anaesthesia time considerably and reduced the need of blood transfusions. Postoperatively thromboembolic episodes and signs of adrenal insufficiency were seen only in the handsewn group, while postoperative febrile conditions were more common in the stapled groups. Ileo-anal dehiscence occurred in two patients without loop ileostomy. Treatment by establishment of a loop ileostomy, local irrigation and administration of antibiotics were successful, the anastomoses healed within 2 weeks and there was no further complications before or after loop closure. Omitting the loop ileostomy saved the patient a further operation and reduces hospital stay and sick leave. After two months of pouch function, patients with handsewn pouches had a lower number of bowel movements (5.5/24 h and 0.8 during the night) than patients with stapled pouches (8.0/24 h and 1.9 during the night). At 12 months, however, the difference between the groups of patients had diminished.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Nodality effects during equivalence class formation: An extension to sight-word reading and concept development.

Three students with moderate disabilities were taught to read and match-to-sample sight words comprising stimulus sets based upon the four food groups. We taught students conditional discriminations within four four-member sets using a single-sample/four-comparison procedure. Students were taught A-B, B-C, and C-D conditional discriminations for each of the four potential stimulus classes. Subsequent probes tested for relations based upon symmetry and one-node and two-node transitivity. The performances for all students indicated that symmetric relations emerged before one-node transitive relations, and that one-node transitive relations emerged before two-node transitive relations. These results are consistent with a pattern of responding, referred to as a "nodality effect," in which relations with fewer nodes are demonstrated prior to the demonstration of relations with a greater number of nodes. These results extend this area of research to sight-word reading for students with moderate disabilities.

Journal Article↗
PubMed1994

Biochemical laboratory data in patients before and after restorative proctocolectomy. A study on 83 patients with a follow-up of 36 months.

From 1980 to 1987 ileoanal pouches were made in 83 patients. Specimen for a set of laboratory analyses were taken preoperatively, during the ileostomy and loop ileostomy periods and repeatedly during 36 months of follow-up. Cobalamine absorption and 14C-triolein breath tests were performed preoperatively in electively operated patients and postoperatively in all patients at 12 and 36 months. Low S-Ca was most pronounced preoperatively in patients who were to undergo acute colectomy (53%). Decreased S-Mg was detected in 16-36% at all stations. None had signs or symptoms of hypomagnesemia. Low S-albumin was rarely seen except for preoperatively in acute patients. Increased IgM was found in 40% of the patients during the loop ileostomy phase compared to 6-10% preoperatively. Substantially increased orosomucoid and/or haptoglobin were seen in patients during the functional periods but these increased values could not be correlated to episodes with acute pouchitis. High values of S-ALAT and ALP were much more frequent during the loop ileostomy periods than it was preoperatively and during pouch function. Low S-haemoglobin and/or iron were noticed during the functional period in 3-8% and 10-16%, respectively. Severe anaemia, due to iron deficiency developed in one patient after 2.5 years of pouch function. Preoperatively, slight decreases of S-B12 were found in 13% and impaired cobalamine absorption was revealed in 38% of the electively operated patients. The corresponding figures were 3% and 31% after 12 months and 5% and 36% after 36 months of follow-up, respectively. B12 substitution was given to in all 8 patients during the follow-ups. Lipid absorption was disturbed in 38% preoperatively and in 35% and 41% at 12 and 36 months, postoperatively.

Adenomatous Polyposis Coli↗
PubMed1992

Highly malignant carcinoma in chronic ulcerative colitis without preceding dysplasia or DNA aneuploidy. Report of a case.

A 41-year-old female with a history of total ulcerative colitis for 15 years is presented. After eight years, she was enrolled in a colonoscopic surveillance program with regular examinations every second year and with biopsy sampling for histologic assessment of dysplasia as well as for flow cytometric analysis. Neither dysplasia nor DNA aneupoloidy developed during the course of the follow-up, but, after seven years, the patient developed a rapidly growing malignant stricture in the lower rectum. At the time of diagnosis, a local gluteal metastasis was found. Following preoperative radiation therapy, laparotomy disclosed a rectal cancer with local growth in the pelvis. Despite an attempt to perform curative surgery, the patient deteriorated and died within four months after the diagnosis. The carcinoma was of a poorly differentiated, mucinous, signet ring cell type, and DNA analyses of both the tumor and its metastases were diploid. Retrospective analyses of mucin content in colonoscopic biopsies showed a gradual shift from sulfated mucin to sialomucin. This case underlines the fact that even rigorous follow-ups offer no absolute guarantee against incurable malignancy in surveillance programs for ulcerative colitis despite the inclusion of DNA analyses.

Adenocarcinoma, Mucinous↗
PubMed1991

Dysplasia and DNA aneuploidy in a pelvic pouch. Report of a case.

A patient with an 18-year history of ulcerative colitis was operated on with colectomy, mucosal proctectomy, ileoanal anastomosis, and an S-type pelvic pouch due to intractable chronic continuous disease. The patient was followed by endoscopic controls and biopsy sampling from the pouch at regular intervals. A gradual development of severe atrophy in the ileal mucosa was followed by the development of low grade dysplasia. At the most recent endoscopic control, 4 years after the construction of the pouch, biopsies were sampled also for flow cytometric DNA analyses. DNA aneuploidy was detected in a biopsy from the center of the pouch, and a biopsy taken immediately adjacent showed low grade dysplasia. These findings underline the importance of endoscopic follow-up after construction of a pelvic pouch and focus attention to the potential of malignant transformation of the mucosa.

Adult↗
PubMed1990

Anal manometry with microtransducer technique before and after restorative proctocolectomy. Sphincter function and clinical correlations.

Anal manometry, with microtransducer technique, was performed in 55 patients after restorative proctocolectomy. Forty-two patients were followed regularly from before surgery until 12 months after surgery, and 23 patients until 24 months of function. Postoperatively, sphincter function was severely impaired. At 12 months, the mean height was less than 60 percent, mean area less than 50 percent, and mean length less than 90 percent of the preoperative values of the high pressure zone. There was no improvement between 12 and 24 months. Mean maximal squeeze pressure was restored at 12 months. Rectoanal inhibitory reflex was constantly present preoperatively, but in only 4 of 30 patients, postoperatively. Those patients with preoperative resting pressure 100 cm H2O or greater had significantly higher resting tones at 12 months than those with less than 100 cm H2O. Patients with 5 or fewer bowel movements every 24 hours had significantly higher resting tones than those with more than 6 movements every 24 hours (66 vs. 45 cm H2O). Patients with deferral 60 minutes or greater had significantly higher resting pressures than those with deferral less than 30 minutes (65 vs. 44 cm H2O). No correlation was found between resting pressure and state of continence.

Adult↗
PubMed1990

The "recall effect" in radiotherapy: is subeffective, reparable damage involved?

It has been proposed that lethal mutations among the progeny of a surviving cell could be the basis for the recall effect when chemotherapy is applied subsequent to the repair of normal-tissue injury resulting from a course of radiation therapy. Because radiotherapy is usually multifractionated, the possibility exists that repair of heritable injury of this type could occur between fractions as is the case for sublethal damage. To examine this possibility, the endpoint small-colony formation was used--an endpoint which integrates the effects of a number of radiation-induced aberrancies including lethal mutations--and low-dose-rate irradiation. It was found that, even after net surviving fractions comparable to those sought in radiotherapy were reached, little damage remained expressible as a deficiency in the size of the colony generated from a surviving cell. We conclude that the damage expressible as a lethal mutation is reparable and therefore the recall effect must be attributed to some other cellular mechanism.

Animals↗