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Biomedical subjects

L Zettergren

Publications and source records attributed to L Zettergren.

At least 19 recordsLinked to original sources
PubMed1992

Liver damage from flucloxacillin, cloxacillin and dicloxacillin.

We describe a case of severe cholestatic liver disease, which persisted for 7 years, and was probably induced by flucloxacillin. We also report a survey of 77 liver reactions which were probably or possibly induced by penicillinase-resistant penicillins and spontaneously reported to the Swedish Adverse Drug Reactions Advisory Committee. The reactions were usually cholestatic with a tendency to a protracted course. There is some evidence for an immunoallergic idiosyncratic reaction. The incidence of reported liver reactions was estimated from sales data to be 1.6-2.9 per million DDD (defined daily doses) or, for flucloxacillin 1:11,000-1:30,000 prescriptions. Female sex, age and high daily doses seemed to be associated with higher risk of liver reactions from flucloxacillin.

Chemical and Drug Induced Liver Injury↗
PubMed1990

Liver involvement in Addison's disease.

Three patients admitted because of slightly increased serum aminotransferases were found to have Addison's disease. A review of 16 other patients with Addison's disease who had serum aminotransferase activity [aspartate aminotransferase (ASAT) and alanine aminotransferase (ALAT)] determined prior to treatment revealed one more patient with slightly increased aminotransferase activity that could not be explained by known causes of increased serum aminotransferase levels. In all four of these patients, the enzymes normalized within 1 wk of corticosteroid substitution treatment. Liver biopsy in one patient revealed discrete lymphocytic infiltrates in the portal zones. On the basis of these observations, we recommend that the possibility of Addison's disease should be considered in patients with obscure slight hypertransaminasemia.

Addison Disease↗
PubMed1989

Elevated aminotransferases and alkaline phosphatases in unstable diabetes mellitus without ketoacidosis or hypoglycemia.

Four patients with unstable diabetes mellitus and pronounced elevations of serum aminotransferases and alkaline phosphatases are reported. Thorough investigations revealed no cause for the abnormalities. The enzyme elevations were associated with hepatomegaly, and in some instances, abdominal pain and leg edema. Liver biopsies in all patients showed only marked accumulation of glycogen in the hepatocytes.

Adolescent↗
PubMed1988

Clinicopathologic studies on mesothelioma of the pleura. Differentiated approach to treatment.

A surgical series of 23 patients with pleural mesothelioma is reviewed. Three who had benign localized mesothelioma of fibrous type are alive and well at least 10 years postoperatively. In two others, radically extirpated localized mesothelioma was histologically classified as benign, but later proved to be malignant, causing death from recurrent disease 27 and 79 months postoperatively. Four patients with diffuse malignant mesothelioma underwent pleurectomy or open biopsy and survived for 2-9 months. Radical en-bloc pleuropneumonectomy was performed on 14 patients with diffuse malignant mesothelioma. One patient died postoperatively and the others succumbed to the disease after 3-51 (mean 20) months. The survival time was greater than or equal to 1 year in 62% of the patients and greater than 3 years in 23%. Patient age, histologic tumour type and extent of disease seemed to be important prognostic factors. Despite the generally poor prognosis, the results of radical surgery in this study appear to warrant an aggressive approach to treatment of benign or localized malignant pleural mesothelioma, and possibly also to stage I diffuse malignant mesothelioma of epithelial type.

Adult↗
PubMed1988

Relationship between gallbladder histopathology and ability to concentrate biliary lipids and bilirubin. A study on gallstone patients with functioning gallbladder.

Biliary lipids and bilirubin were measured in hepatic and gallbladder bile obtained at routine cholecystectomy in 35 gallstone patients. The gallbladders had opacified at cholecystography and the cystic ducts were patent at operation. The histologic changes in the gallbladder wall were evaluated by an independent pathologist. Increasing abnormality of the gallbladder wall was shown to be associated with reduced gallbladder contents/hepatic bile ratio of biliary lipids and of bilirubin. The concentrating function of the human gallbladder thus appears to be impaired in proportion to the severity of histologic lesions in its wall. Taken together with earlier findings in vitro, this relationship suggests impaired absorption of electrolytes and water by the gallbladder mucosa, or diffusion of biliary constituents from the lumen of the inflamed gallbladder.

Bile↗
PubMed1984

HBsAg-negative chronic active hepatitis and mixed connective tissue disease syndrome. An unusual association observed in two patients.

Two patients are described who suffered from both HBsAg-negative chronic active hepatitis and mixed connective tissue disease syndrome. The diagnosis of liver disease was made prior to the diagnosis of collagenosis in one of the patients, whereas the opposite was the case in the other. In spite of the fact that symptoms and laboratory data suggesting both diagnoses were present from the moment of presentation, there was a considerable delay in establishing the second diagnosis in both patients. To our knowledge, this is the first report on an association between chronic active hepatitis and mixed connective tissue disease syndrome. It illustrates the difficulties when diagnosing overlap conditions.

Adult↗
PubMed1984

Diagnosis and prognosis in malignant pleural mesothelioma: a prospective study.

In a prospective study of 336 consecutive patients with long-term pleural effusions, 32 cases of malignant mesothelioma were found. Microscopic examination of pleural tissue specimens, preferably selected at thoracoscopy, proved superior to pleural fluid analysis as an aid to correct diagnosis. The epithelial proved to be the most common type of malignant mesothelioma. As an example of the mesothelial cells' multipotent ability, malignant cells were seen transforming into fat-like cells with lipid-containing vacuoles. In the fibrous tumour type, cytological examination of pleural fluid revealed only normal cells. Cells with malignant features were seen in fluid samples from epithelial and biphasic tumour types. The malignant cells often formed tubuli-like aggregates which could be mistaken for adenocarcinoma. Hyaluronic acid was more frequently detected in tissue specimens than in the pleural fluid samples. The morphological type and the patient's age had an impact on the survival time, whereas sex and extensive surgical treatment seemed less important.

Aged↗
PubMed1984

Malignant mesothelioma in two pairs of siblings: is there a hereditary predisposing factor?

Two pairs of siblings with malignant pleural mesothelioma are reported. One sister and brother experienced slight household asbestos exposure during childhood. Two identical-twin brothers were occupationally exposed to asbestos for only 8 years. The occurrence of this rare neoplasm in 2 pairs of siblings indicates that a hereditary predisposing factor may exist.

Aged↗
PubMed1983

Hepatic reactions to cyclofenil.

Thirty patients with hepatic reactions to cyclofenil, a non-steroidal drug with a stimulating effect on ovulation, are reviewed. The liver damage was probably related to metabolic idiosyncrasy, and was reversible in all patients.

Adult↗
PubMed1982

Shrinking pleuritis with atelectasis.

During a 10-year period 28 patients with shrinking pleuritis with atelectasis (SPA) were observed and operated upon. This lesion has been given different names in the literature, for instance rounded atelectasis, pleuroma, pulmonary pseudotumour, and lung folding. All patients except two were operated upon because of a diagnosis of pulmonary tumour. However, at operation no tumour was found. The aetiology and pathogenesis of SPA are discussed on the basis of X-ray, operative, and histopathological findings.

Diagnosis, Differential↗
PubMed1981

Gallbladder function in experimental cholecystitis.

Experimental cholecystitis was induced by implanting gallstones from human beings into the gallbladder of the cat. Three months later the concentrating function of the gallbladder, the motility, and hepatic bile flow were studied by a perfusion technique in the anesthetized animal. Gallbladder function was correlated to morphologic changes. After 3 months, the cystic duct was patent in nine animals and bile was found in the gallbladder. In 17 animals the cystic duct was obstructed and colorless contents were found in the gallbladder. Animals with a patent cystic duct showed slight or moderate inflammation and intact concentrating activity in the gallbladder, whereas animals with obstructed animals had pronounced inflammation and continuous fluid "secretion" into the lumen. Both groups had increased bile outflow from the liver. Indomethacin, a prostaglandin synthetase inhibitor, promptly reversed gallbladder fluid "secretion" into absorption and reduced the increased bile flow to a normal level. These results are discussed in relation to clinical findings in man. A mechanism by which prostaglandins are responsible for the inflammatory gallbladder "secretion" and the increased bile flow from the liver is proposed.

Animals↗
PubMed1980

Localization of tissue fibrinolysis in the gastrointestinal tract.

Tissue fibrinolysis in the stomach and intestine of the rat was studied with a histochemical technique. After perfusion of blood vessels to reduce the influence of circulating plasminogen activator and inhibitor fibrinlysis was localized mainly to submucosal arteries and to the serosa of the gastrointestinal tract. This is opposite to previous observations, in which tissue fibrinolysis in the gastrointestinal tract was suggested to be mainly localized to veins. A method for semiquantitative analysis of tissue fibrolysis in the rat stomach is described.

Animals↗
PubMed1978

Collagenase isolation and 45Ca efflux studies of human islets of Langerhans.

22 human pancreases were removed soon after circulatory arrest from donors aged 15--63 years. Part of the pancreas was used for isolation of islets by the collagenase technique. The mean yield +/- SEM, expressed as the number of islets isolated from 4 g pancreas was 79 +/- 15. The yield varied considerably even when the pancreas was removed immediately after circulatory arrest and the histology was normal, and there was no correlation with the age of the donors. The islet content of insulin (ng/microgram dry islet) was 8.5 +/- 1.2 (mean +/- SEM). Isolated islets were loaded with 45Ca in the presence of 20 mM glucose and placed in a perfusion apparatus for further studies of the 45Ca washout. The decrease of washout of radioactivity in Ca2+-deficient medium offers support for the existence of a Ca2+-Ca2+ exchange process. When added in a concentration of 20 mM, glucose tended to stimulate 45Ca efflux in perfusion medium of ordinary ionic composition but inhibited this process when the medium was deficient in Ca2+. Exposure to the calcium ionophore X-537A resulted in immediate stimulation of of 45Ca efflux from human islets as previously observed for islets from rats and mice. This suggests that Ca2+ has a direct regulatory role for insulin release also in humans.

Adolescent↗