PubMed Health⌕ Search

Biomedical subjects

L Hellström

Publications and source records attributed to L Hellström.

At least 37 records · Page 2Linked to original sources

Regulation of lipolysis in fat cells of obese women during long-term hypocaloric diet.

OBJECTIVE: To investigate the influence of four weeks treatment with a strictly defined very low calorie diet (VLCD) on the regulation of adipocyte matabolism in vitro in subcutaneous fat cells of obese subjects. DESIGN: Prospective study. SUBJECTS: Nine obese, but otherwise healthy and drug-free women aged 26-48 years with BMI 36.4-51.9 kg/m2 were investigated before and during the fourth week on a calorie restricted diet. MEASUREMENTS: A subcutaneous adipose tissue biopsy was obtained from the abdominal area. Isolated fat cells were prepared and incubated in vitro with different agents acting on lipolysis at defined steps in the lipolytic cascade. Glycerol (lipolytic index), hormone-sensitive lipase activity and incorporation of glucose into lipids were measured. RESULTS: VLCD caused a two-fold rise in basal lipolysis (p < 0.005). In spite of this, the maximal lipolytic response of noradrenaline, isoprenaline (non-selective beta-adrenoceptor agonist), dobutamine (beta 1-adrenoceptor agonist), terbutaline (beta 2-adrenoceptor agonist), CGP 12177 (beta 3-adrenoceptor agonist), forskolin (stimulating adenylyl cyclase), dibuturyl cyclic AMP and 8-bromo cyclic AMP (cyclic AMP analogues resistant or sensitive to phosphodiesterase, respectively) were maintained. No differences were found in the hormone-sensitive lipase activity before or during VLCD. The specific alpha 2-adrenoceptor agonist UK 14304 was equally effective in inducing antilipolysis both before and during calorie restriction. However, during VLCD, the sensitivity and maximal antilipolytic effect of insulin were significantly reduced (p < 0.05) and the ability of insulin to stimulate lipogenesis was almost completely blunted. CONCLUSIONS: Four weeks of VLCD induced elevated basal lipolysis, a resistance to the ability of insulin to induce antilipolysis and lipogenesis in subcutaneous fat cells, but preserved lipolytic catecholamine action. These are factors that together promote fat mobilization and thereby weight reduction during long-term calorie restriction.

8-Bromo Cyclic Adenosine Monophosphate↗

Enzymuria in a population living near a cadmium battery plant.

OBJECTIVES: To study the body burden of cadmium and signs of tubular dysfunction in a rural population living near a closed nickel cadmium battery plant. METHODS: Cadmium and N-acetyl-beta-glucosaminidase (NAG) in urine were measured in 72 subjects who lived close to the plant. RESULTS: Residents living close to the plant had higher median urinary cadmium concentrations than those living farther away (1.01 v 0.46 nmol/mmol creatinine) and than a control group (0.2 nmol/mmol creatinine). There was a significant correlation between urinary cadmium and the excretion of NAG in urine as well as signs of tubular dysfunction in residents who excreted urinary cadmium above 0.5 nmol/mmol creatinine. CONCLUSION: Tubular dysfunction may appear in environmentally exposed subjects at lower cadmium body burdens than previously anticipated.

Acetylglucosaminidase↗

Adapting incontinent patients incontinence aids to their leakage volumes.

The importance of adapting incontinence aids according to the patients leakage volume and comfort was investigated in 28 urinary incontinent 85-year-old men and women who were living at home. The patients incontinence was quantified by a 48-hour pad test and was graded as slight (max. leakage per pad < 5 g; total leakage/48 h < 30 g), moderate (max. leakage per pad 5-15 g; total leakage/48 h 30-70 g) or severe (max. leakage per pad > 15 g; total leakage/48 h > 70 g). Four women had slight urinary incontinence, eight were moderately incontinent and nine were severely incontinent. The corresponding figures for the seven men were as follows: slight, one; moderate, one; severe, five. After the primary assessment, incontinence aids were prescribed based on the measured leakage volumes. The correctly selected and adapted incontinence aid brought the patient better comfort and security. The importance of careful information and instructions how to apply the pad is emphasised. There is also a need to see the patient again at intervals as leakage volumes may vary. Thus, smaller packages of pads should be supplied as the choice of pad may need to be modified. The latter is also important from a financial point of view as the expense of otherwise wasted pads would unnecessarily increase costs.

Adaptation, Psychological↗

Lipolytic catecholamine resistance due to decreased beta 2-adrenoceptor expression in fat cells.

The existence of lipolytic beta-adrenoceptor (BAR) resistance was investigated in vivo and in isolated abdominal subcutaneous adipocytes in 65 healthy and drug-free subjects. The concentration of isoprenaline (nonselective BAR agonist) causing half-maximum lipolysis effect (ED50) varied bimodally and 10(6)-fold between individuals but was almost constant in the same subject when measured two times at rest or before and 30 min after exercise. The subjects were categorized as having either high or low isoprenaline sensitivity. The former group had a 50% reduced in vivo lipolytic response to exercise and mental stress, despite a 50% increased plasma noradrenaline response (P < 0.01) and a 350% increased plasma adrenaline response (P < 0.02). In fat cells the lipolytic ED50 values for noradrenaline and terbutaline (BAR2 agonist) were 10 times lower (P < 0.001) in low-sensitive subjects, but the maximum lipolytic actions of these agents (and of isoprenaline) were similar in both groups. The action on lipolysis of dobutamine (BAR1 agonist), forskolin (stimulating adenylate cyclase), dibutyryl cyclic AMP (activating protein kinase), clonidine (alpha 2-adrenergic agonist), or phenyl isopropyladenosine (adenosine receptor agonist) were almost identical in high- and low-sensitivity subjects. ED50 for isoprenaline correlated with ED50 for terbutaline (r = 0.75), but not with ED50 for dobutamine. In high-sensitivity subjects the number of BAR2 was almost three-fold increased (P < 0.002) and the steady-state adipocyte mRNA level for BAR2 was sixfold increased (P < 0.005). BAR2 affinity as well as BAR1 number, affinity and mRNA expression were similar in both groups. In 11 cholecystectomy patients (otherwise healthy) lipolytic ED50 for beta agonists correlated in omental and subcutaneous fat cells (r = 0.85 for isoprenaline; r = 0.95 for terbutaline). In conclusion, lipolytic resistance to catecholamines is present in vivo in apparently healthy subjects due to reduced expression of BAR2 in adipocytes.

Adipose Tissue↗

Randomized study of mammography screening--preliminary report on mortality in the Stockholm trial.

In March 1981, 40,318 women in Stockholm, aged 40-64, entered a randomized trial of breast cancer screening by single-view mammography alone versus no intervention in a control group of 20,000 women. The attendance rate during the first screening round was 81 per cent and the cancer detection rate was 4.0 per 1000 women. The detection the rate fell to 3.1 per 1000 in the second round, which was completed in October 1985. During 1986 the controlled design of the study was broken and the control women were invited once to screening which was completed the same year. A total of 428 cases of breast cancer were thus diagnosed in the study group and 439 in the adjusted control group. After a mean follow-up of 7.4 years the number of breast cancer deaths in the study and control groups was 39 and 30 respectively. The relative risk of breast cancer death (screening versus control) was 0.71 (95 per cent confidence interval: 0.4-1.2). Among women older than 50 years at entry the relative risk was 0.57 (95 percent confidence interval: 0.3-1.1). Cancer deaths among women under 50 were few and perhaps because of this no mortality reduction was seen in this age group. The estimate of mortality reduction lies between the results from two earlier Swedish randomized controlled trials.

Adult↗

Left ventricular beta 1 and beta 2 adrenoceptor mRNA expression in normal and volume overloaded human heart.

STUDY OBJECTIVE: The aim was to determine gene expressions of beta 1 and beta 2 adrenoceptor subtypes (BAR-1, BAR-2) in normal and volume overloaded human heart. DESIGN: Tissue mRNA levels were determined by excess solution hybridisation using 35S-UTP labelled BAR-1 and BAR-2 cRNA probes. MATERIAL: Atrium, right and left ventricular subendocardium, and papillary muscle from donor hearts and papillary muscle from patients operated for mitral stenosis and mitral regurgitation were studied. MEASUREMENTS AND MAIN RESULTS: The basal levels of myocardial BAR-1 and BAR-2 mRNA expression were similar to the levels in human adipose tissue that have been reported previously from our laboratory (10-15 amol mRNA.micrograms-1 total nucleic acids). No differences in BAR-1 and BAR-2 mRNA expression were observed between various parts of the normal heart. In papillary muscle, BAR-1 and BAR-2 mRNA levels were 8.8 (SEM 5.1) and 10.2(6.6) amol.micrograms-1 total nucleic acids, respectively. Furthermore, no differences in BAR mRNA expression were observed between myocardium subjected to mitral stenosis as compared to normal myocardium. On the other hand, patients with mitral regurgitation expressed significantly lower levels of both BAR-1 and BAR-2 mRNA, at 4.8(1.0) (p less than 0.05) and 2.6(1.1) (p less than 0.001) amol.micrograms-1 total nucleic acids, respectively. The ratio BAR-1/BAR-2 mRNA was higher (p less than 0.01) in mitral regurgitation than in the normal heart. CONCLUSIONS: Myocardium from different parts of the normal human heart, where different pressure work is generated, express similar levels of BAR-1 and BAR-2 mRNA. With volume load a significant decrease in BAR mRNA levels was observed, which was more marked for BAR-2 mRNA. This difference in specific mRNA levels in patients with mitral regurgitation indicates an independent regulation of the expression of these two receptor subtypes.

Adolescent↗

A comparison between experienced and objectively demonstrated urinary leakage in 85-year old men and women.

The ability of 37 urinary incontinent 85-year old men and women to perform the 48-h pad test in their home environment was studied. Assessment of the magnitude of urinary incontinence by the 48-h pad test was compared with a subjective assessment, performed by the men and women themselves. Twenty-eight of the 37 men and women successfully performed the 48-h pad test. Early signs of dementia and defective vision were the main reasons for not completing the test successfully. The six women who considered their urinary incontinence to be slight had a maximum leakage per pad of 5.3 +/- 1.4 g. The corresponding figure for women with moderate incontinence was 48.8 +/- 12.3 g. None of the women considered their incontinence to be severe, even though eight of the women had a leakage per pad of greater than 30 g. Six men considered their incontinence to be moderate (25.0 +/- 8.1 g) and one man considered his incontinence to be severe (31 g/pad). Fourteen of the 28 men and women underestimated the magnitude of their urinary incontinence.

Aged↗

The prevalence of urinary incontinence and use of incontinence aids in 85-year-old men and women.

The prevalence of urinary incontinence and the use of incontinence aids was investigated in 85-year-old men and women resident in the city of Göteborg. The overall prevalence of urinary incontinence was 37.2%. Urinary incontinence was more prevalent (p less than 0.001) in women (43.2%) than men (24.0%), and in residents of a nursing home or hospital (83.9%) than in men and women living at home (29.4%). Urinary incontinence was more commonly encountered in men with neurological (p less than 0.001) and respiratory (p less than 0.05) illnesses, and in women suffering from cardiovascular (p less than 0.05), neurological (p less than 0.001) and urogenital (p less than 0.01) illnesses. Incontinence aids were used more often (p less than 0.001) by incontinent women (67.9%) then men (42.9%) living in the community, and were used by 86.4% of the incontinent men and 91.5% of the incontinent women living in an institution. Pads were the commonest form of incontinence aid used, irrespective of whether the men and women lived in the community or in an institution. Indwelling urinary catheters were used by only 2% of the 85-year-old men and women.

Aged↗

Beta-adrenoceptor expression in human fat cells from different regions.

The expression of beta-adrenoceptors (BAR) was investigated in abdominal and gluteal fat cells of 32 nonobese men and women using radioligand binding and RNA excess solution hybridization. In both sexes the number of BAR binding sites was about twice as high in abdominal as in gluteal fat cells (P less than 0.01). Northern blot analysis of total RNA from adipose tissue showed hybridization of the BAR1 probe to an mRNA species of about 2.5 kb and of the BAR2 probe to an mRNA species of approximately 2.2 kb. The steady-state mRNA levels of BAR 1 and BAR 2 were also about twice as high in abdominal as in gluteal adipocytes of men and women (P less than 0.01). In abdominal fat cells the mRNA levels were approximately 45 and 30 molecules/cell for BAR1 and BAR2, respectively. There were no regional or sex variations in BAR 1 and BAR 2 mRNA stability. The apparent half-life of mRNA for both receptor subtypes was approximately 6 h in both regions. The mRNA levels for beta actin did not differ between the two regions in either sex. Thus, differences in expression of the genes encoding for BAR 1 and BAR 2 can explain why abdominal fat cells have more BAR than gluteal fat cells. This variation in gene expression may be a molecular mechanism underlying the well known regional differences in catecholamine-induced lipolysis activity between central and peripheral adipose tissue.

Adipose Tissue↗

Glucocorticoid receptor messenger ribonucleic acid in different regions of human adipose tissue.

The expression of glucocorticoid receptor (GR) messenger RNA (mRNA) was investigated in sc adipose tissue and isolated adipocytes from the abdominal and gluteal regions in men and women using a human GR complementary RNA probe. GR mRNA levels were 2-fold higher in female than in male abdominal tissue or adipocytes, whereas in gluteal tissue or adipocytes no sex differences were observed. GR mRNA levels in female abdominal adipocytes were 50% higher than in corresponding female gluteal adipocytes; the opposite was observed corresponding in males. Northern blot analysis of total cellular RNA isolated from abdominal and gluteal adipocytes showed hybridization of the human GR probe to an RNA species of approximately 7.1 kilobases in both regions. No sex or regional differences in GR mRNA stability were observed. The human metallothionein II (hMTII) mRNA, which is regulated by glucocorticoids at the transcriptional level, showed an opposite sex and regional pattern as GR mRNA. However, in gluteal adipose tissue no sex differences were observed in hMTII mRNA levels. The expression of beta-actin mRNA, which is not regulated by glucocorticoids, showed no sex or regional variation. By immunocytochemistry, using an anti-GR-monoclonal antibody, cytoplasmic as well as nuclear staining for GR was demonstrated in both sexes and both regions. In conclusion, variations in GR mRNA levels between sexes and body regions may explain the well known sex and tissue differences in effects of glucocorticoids on human adipose tissue.

Abdomen↗

Beta-adrenoreceptor subtype expression in human liver.

The pharmacological and gene expressions of beta 1- and beta 2-adrenoceptor subtypes (BAR1 and BAR2) were investigated in human liver by radioligand binding assays, adenylate cyclase experiments, and RNA excess solution hybridization. [125I]Cyanopinodolol, nonlabeled adrenergic agents, and BAR1/BAR2 cRNA were used as probes. The relationship between binding sites for BAR1 and BAR2 was markedly different from that between the basal mRNA expression for the two receptor subtypes. Plasma membranes as well as a microsomel-enriched fraction contained binding sites only for BAR2. The potency of BAR agonists and antagonists in stimulating adenylate cyclase activity of plasma membranes was typical of a BAR2 response. Northern blot analysis of total cellular RNA isolated from liver tissue showed hybridization of the BAR1 probe to a mRNA species of 2.5-2.6 kilobases and of the BAR2 probe to a mRNA species of 2.2-2.3 kilobases. The basal level of BAR1 mRNA was 5-fold higher than of BAR2 mRNA, as assayed by solution hybridization. No difference in BAR subtype mRNA stability was observed, as indicated by a mRNA half-life of approximately 5.5 h for both receptor subtypes. It is concluded that specific factors are involved in the steady state regulation of BAR subtype expression in human liver. This tissue contains solely BAR2 owing to a posttranscriptional block of basal BAR1 expression.

Adenylyl Cyclases↗

Additional value of fine-needle aspiration biopsy in a mammographic screening trial.

The Stockholm breast cancer screening trial used single-view mammography as the sole screening method. A majority (63 per cent) of the mammographic selected cases from the first two screening rounds had uncertain mammograms, coded as 3 on an ordinal scale from 1 to 5, where 1 and 2 are dismissed as normal mammograms and 5 stands for a typical cancer. In this group of uncertain mammograms 30 cases were malignant and 431 were non-malignant. The aim of this study was to examine whether surgical biopsy in this group could be replaced by fine-needle aspiration (FNA) biopsy, combined with the information from the mammogram and clinical examination, and whether this diagnostic strategy could select the malignant cases with a high sensitivity. FNA biopsy selected 25 of the 30 mammary carcinomas as definite malignancy or atypia, with a sensitivity of 83 per cent (95 per cent confidence interval: 69-96 per cent), and combined with the information from the mammogram and clinical examination 29 of the malignancies were selected with a sensitivity of 97 per cent (95 per cent confidence interval: 83-100 per cent). In 398 of 431 non-malignant cases the diagnosis was established with the triple diagnostic approach without needing a surgical biopsy. In a clinical follow-up study, up to 64 months after the first screening round, only one false negative case was found, included in the group of 30 malignancies described above. With this strategy the rate of negative surgical biopsies was reduced by 90 per cent in the group with uncertain mammograms and without considerably impairing the reliability of the results.

Adult↗

The Stockholm breast cancer screening trial--5-year results and stage at discovery.

In screening programmes it is important to assess a preliminary effectiveness of the screening method as soon as possible in order to forecast survival figures. In March 1981 a controlled single-view mammographic screening trial for breast cancer was started in the south of Stockholm. The population invited for screening mammography consisted of 40,000 women aged 40-64 years, and 20,000 women served as a well-defined control group. The main aim of the trial was to determine whether repeated mammographic screening could reduce the mortality in the study population (SP) compared to the control population (CP). The cumulative number of advanced mammary carcinomas in the screening and the control populations from the first five years of screening have shown a tendency towards more favourable stages in the screened population aged 40-64 years. A breakdown by age suggests an effect in age group 50-59 years, but not yet in age groups 40-49 and 60-64 years. When comparing the rates of stage II+ cancer, an increased number is found in the study group. As the total rate of breast cancer is higher in SP than in CP, there ought to be a concealed group of stage II+ cancers in the CP which makes the comparison biased. A new approach has been designed, where an estimation of the 'hidden' number of stage II+ cancers in CP is added to the clinically detected cases, and in this respect a comparison has shown a decrease in the cumulative number of advanced cancers in the SP in relation to the CP (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Diphtheria in Stockholm, with a theory concerning transmission.

Since 1984, diphtheria has been diagnosed in Sweden, mainly among men abusing alcohol. During the first half of 1986, eight cases of diphtheria were discovered in the city of Stockholm. The first three were among men abusing alcohol. The following five cases had no connection with them. These five persons were employed in two companies housed in the same building. The only connection between them was that they ate their lunch at the same restaurant. One alcohol-abusing man had worked temporarily in the kitchen of this restaurant during the week before the five cases of diphtheria arose. He knew one of the first three patients well. A throat swab taken from him a month after the five cases had been diagnosed was negative. It was suspected however, that this man might have been a carrier of Corynebacterium diphtheriae during the week that he worked in the kitchen. Tests for C. diphtheriae antitoxin revealed that the kitchen staff had high antitoxin titres although they lacked a history of basic immunisation. Even so, C. diphtheriae could not be isolated from their throats and it has not been possible to establish the mode of transmission. The most reasonable theory of transmission is that the organism was introduced into the kitchen by the man employed there temporarily and that it was spread by food served in the restaurant. This theory has not been proved but is discussed in order to facilitate future investigations of a similar outbreak.

Adult↗

Non-palpable invasive breast carcinomas from the Stockholm screening project.

Sixty-six non-palpable, invasive mammary adenocarcinomas from the Stockholm mammography screening project were studied with respect to histopathology. In 53 of these tumors estrogen receptor (ER) content was estimated and in 30 of them also the DNA distribution pattern. The tumors were predominantly of low or intermediate histological malignancy grade and ER-rich, whereas the distribution of DNA ploidy equalled that found in a non-selected tumor material. Only 2 tumors recurred during follow-up (median 51 months), indicating that non-palpable breast carcinomas represent a prognostically favourable subset in spite of a relatively high proportion of aneuploid tumors.

Adenocarcinoma↗