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Biomedical subjects

N E Larsen

Publications and source records attributed to N E Larsen.

At least 55 records · Page 3Linked to original sources

The effects of tumor-promoting phorbol esters on human granulopoiesis in vitro.

In order to determine whether the tumor-promoting phorbol esters are capable of inducing normal human committed granulocytic-monocytic progenitor cells (CFUc) to proliferate and differentiate in the absence of granulocyte-monocyte colony-stimulating activity (CSA), we studied the effects of these compounds on human granulopoiesis in vitro. We found that when light-density human marrow cells or peripheral blood leukocytes were depleted of adherent cells and then incubated in semisolid tissue culture medium under conditions optimal for CFUc growth, phorbol myristate acetate (PMA) and its congeners produced no measurable stimulatory effect on the proliferation of CFUc in the absence of added CSA. Likewise, when light-density marrow cells that had not been depleted of adherent cells were plated in the cultures, no stimulation of CFUc colony growth resulted from the addition of PMA. However, when light-density peripheral blood leukocytes were used as a target source of CFUc without first subjecting them to adherence separation, enhanced proliferation and differentiation of CFUc were noted in cultures that contained PMA. To investigate the possibility that CSA production by monocytes in these cultures in response to activation by PMA might account for the enhanced colony formation that we observed, we incubated isolated peripheral blood monocytes in short-term liquid suspension cultures and found that in the presence of PMA, large quantities of CSA were secreted into the surrounding medium. Finally, we noted that when marrow cell suspensions were suboptimally stimulated by low concentrations of CSA added to the cultures, the effects of PMA on CFUc proliferation were unpredictable, enhancing colony formation in some cases and inhibiting it in others. Our data indicate that although the tumor-promoting phorbol esters do not appear capable of directly stimulating the proliferation or differentiation of human CFUc in the absence of CSA, they may do so indirectly by causing auxiliary cells such as monocytes to secrete CSA.

Bone Marrow↗

Lack of interaction between cimetidine and carbamazepine.

In order to investigate a possible interaction between cimetidine and carbamazepine (CBZ) 7 otherwise healthy epileptic patients on a long-term monotherapy with CBZ were given cimetidine (1 g daily) for 7 days. No significant alterations in steady-state plasma concentration of CBZ and the 10,11-epoxide metabolite (CBZ-E) were demonstrated.

Adult↗

Pharmacokinetics of cimetidine in patients undergoing hemodialysis.

In order to establish improved guidelines for dosage adjustments of cimetidine before and during hemodialysis, the kinetics of this drug was investigated in 7 uremic patients undergoing regular hemodialysis. The absorption fraction was found to be 0.75 (range 0.61-0.86), the terminal half-life in plasma between 138 and 238 min, the total body clearance (Cltotal) between 178 and 337 ml/min, and the apparent volume of distribution about 1 l/kg. During hemodialysis no excess amounts of cimetidine were removed from serum. In 3 patients a weak rebound phenomenon was seen after hemodialysis. Based on the Cltotal obtained in this study, dosage schemes producing a 24-hours mean steady state concentration from 0.60 (2.38) to 1.20 (4.76) mg/l (mumol/l) are suggested.

Adult↗

Unchanged biochemical indices of bone turnover despite fluctuations in 1,25-dihydroxyvitamin D during the menstrual cycle.

To examine the effect of endogenous oestrogens on calcium metabolism during the menstrual cycle, fasting blood and urinary samples were obtained every day throughout the menstrual cycle in 5 young women. Bone turnover was estimated by serum alkaline phosphatase and fasting urinary excretions of hydroxyproline and calcium. Serum levels of oestradiol (E2), oestrone (E1), and androstenedione (A) showed the well known cyclic fluctuations, the serum 1,25-dihydroxyvitamin D (1,25(OH)2D) nearly doubled from the early follicular phase to the time of ovulation, although 25-hydroxyvitamin D (25OHD) and 24,25-dihydroxyvitamin D (24,25(OH)2D) were almost unchanged. No correlation between the rise in the serum 1,25(OH)2D level and the measured parameters of calcium metabolism was observed. In view of these findings, the 1,25(OH)2D3 serum concentration measured in women with functioning ovaries can only be interpreted in the context of the menstrual cycle. The published normal range in women for the metabolite may also require reinterpretation.

Adult↗

Protection of opiate receptors in NG108-15 against modification by N-ethylmaleimide.

Two different -SH groups associated with the opiate receptors of the mouse neuroblastoma X rat glioma hybrid NG108-15 have been identified. Modification of these by N-ethylmaleimide (NEM) (presumed to be via alkylation) or by para-chloromercuribenzoic acid (presumed to be via formation of mercury adducts) decreases the binding of both opiate agonists and antagonists to these receptors. Agonist binding is more sensitive than antagonist binding to modification by NEM. Losses in antagonist binding are accounted for totally by decreases in the number of binding sites; there are no corresponding losses in antagonist affinity. Losses of antagonist binding exhibit a pseudo-first order rate constant; the modification of only one such group completely destroys the binding site. Both agonists and antagonists protect against modification of this group by NEM. Sodium and lithium, but not GTP, also protect this group, indicating that the action of these monovalent cations is directly on the receptor moiety. Losses in agonist binding stem not only from decreases in receptor number but also from selective losses in affinity. This -SH group appears to be different from the one at the binding site as sodium, GTP, and antagonist ligands do not protect against losses in agonist affinity. Agonist high affinity also is lost in a pseudo-first order fashion indicating that an alteration of only one -SH group per receptor complex is sufficient to produce this effect. The possible roles of two sulfhydryls in opiate receptor function are discussed.

Animals↗

Bioavailability of naproxen tablets and suppositories in steady state.

Serum profiles were obtained from patients with rheumatoid arthritis after treatment with naproxen tablets and suppositories for 10 days to assure steady state conditions. The serum concentrations immediately before dose intake correlated well with the area under the concentration curve (AUC) when 250 mg naproxen tablets were taken 12-hourly (r = 0.85) and when 500 mg naproxen was given as tablets or as suppositories once daily in the evening (r = 0.83). These fixed times for blood samplings should be used in clinical trials with naproxen. Naproxen was measured by mass fragmentography. The mean steady state concentration and the mean half-life, calculated from the 12-hourly dosage schedule, were 45.0 +/- 1.7 mg/l and 15.2 +/- 1.4 hours, respectively. Doubling the dose from 250 mg to 500 mg b.i.d. increased the AUC by 30%. Average serum profiles for tablets and suppositories were very similar and gave a relative bioavailability of suppositories compared to tablets of 103% +/- 4%, suggesting comparable efficacy of the two administration forms.

Adult↗

Dose-response relationships of perphenazine in the treatment of acute psychoses.

A group of 26 acute psychotic patients received continuous oral treatment with perphenazine for a period of 5 weeks. Once-weekly blood samples were drawn for measurements of perphenazine levels and, simultaneously, the therapeutic outcome was registered. Another 26 acute psychotic patients received continuous oral treatment with perphenazine for a period of up to 4 weeks. A single blood sample was drawn and the perphenazine concentration was related to the appearance of extrapyramidal side effects. The following conclusions were made: (1) a high risk of provoking extrapyramidal side effects was associated with plasma levels of perphenazine above 3 nmol/l; (2) plasma levels below 2 nmol/l were associated with a poor therapeutic outcome; (3) a 'therapeutic window' between 2 and 3 nmol/l gives maximal therapeutic effect with a low risk of provoking extrapyramidal side effects.

Acute Disease↗

Measurement of goal attainment in clinical and health care programs.

Goal attainment scaling (GAS) is a method of measurement that attempts to tailor measures to the relevant and often unique characteristics of an event, individual, program, or organization. The general approach is common in industry, management, service delivery, and most forms of contractual arrangements or agreements. GAS has quantification characteristics that make it useful in a variety of research and management areas, and it is popularly used as a clinical and educational facilitator. This article describes the method within a recent historical context, relating the method to current thinking and problems in evaluation, and attempts to make the method accessible to potential users. Special emphasis is placed on the use of analyses that assess readiness to change or adopt new practices.

Community Mental Health Centers↗

Pathophysiological mechanisms of estrogen effect on bone metabolism. Dose-response relationships in early postmenopausal women.

Dose-response relationships of estrogen (E) on indices of calcium balance and bone activity were studied in normal early postmenopausal women. Calcium balance was estimated by changes in forearm bone mineral content, measured by photon absorptiometry. Bone activity was estimated by serum alkaline phosphatases (S-aPh), indicating bone formation, and by fasting urinary excretion of hydroxyproline (U-HyPro) and calcium (U-Ca), indicating bone resorption. A total of 92 female volunteers were randomized to 12 months' treatment with placebo or one of three different doses (high, medium, or low) of natural estrogens (17 beta-estradiol and estriol, 4/2, 2/1, and 1/0.5 mg, respectively), sequentially combined with the same dose (1 mg) of norethisterone acetate for 10 of the 28 cycle days. The trial was completed by 79 women. Bone mineral content declined by 2% (P less than 0.001) in the placebo group, remained constant in the low hormone group and increased by 0.8% (P less than 0.05) and 1.5% (P less than 0.01), respectively, in the medium and high hormone groups. S-aPh decreased gradually and equally by 20-25% in the three hormone groups and U-HyPro and U-Ca decreased by 30-40% during 1-yr hormone treatment, irrespective of dose. The decrease in these three indices occurred practically without exceptions. Compared to the values found in 48 normal premenopausal women the untreated postmenopausal women had increased values of S-aPh (P less than 0.001), U-HyPro (P less than 0.01), and U-Ca (P less than 0.001), and no pretreatment values were below the normal premenopausal range. After treatment the mean values of S-aPh and U-HyPro were slightly lower than the premenopausal mean values (P less than 0.01). These data strongly support the major importance of E deficiency for early postmenopausal bone loss, which is prevented by even a small substitution dose of E.

Adult↗

Preparation and application of a photoreactive thrombin analogue: binding to human platelets.

alpha-Thrombin has previously been shown to bind to specific, saturable glycoproteins on the platelet surface. Modification of the thrombin active site with tosyllysyl chloromethyl ketone (TosLysCH2Cl) does not alter thrombin's binding characteristics. Interaction of alpha-thrombin with high-affinity binding sites (KD = 10(-9) M) initiates the platelet response which involves proteolytic hydrolysis of this glycoprotein. Although TosLysCH2Cl--thrombin binds to and competes for the same sites as alpha-thrombin, it cannot induce platelet stimulation because it is enzymatically inactive. In this study, we describe the preparation and application of photoreactive tritium-labeled thrombin analogues. The alpha-thrombin derivative retains its platelet-stimulating and enzymatic activities and, upon photoactivation, covalently binds to specific platelet membrane components. When freshly washed human platelets are exposed to less than saturation doses (less than or equal to 2 nM) of the thrombin derivatives in the dark and photoactivated, a single labeled complex is detected. The same experiment with greater than saturating doses (greater than or equal to 20 nM) of the thrombin derivative yields a similar complex as well as two additional ones. Molecular weight estimates of these thrombin-bound complexes were obtained by gel filtration and NaDodSO4--polyacrylamide gel electrophoresis. The low dose (high affinity) complex with TosLysCH2Cl--thrombin has an approximate molecular weight of 200 000, while that with active alpha-thrombin is smaller, approximately 120 000, due to enzymatic cleavage. The additional complexes detected with the high thrombin dose had estimated molecular weights of 400 000 and 46 000, respectively, and appeared to be the same for TosLysCH2Cl--thrombin and for the alpha-thrombin coupled platelets. These isolated complexes appear to correspond to the two previously detected populations of thrombin binding sites on the platelet.

Azides↗

Plasma levels of perphenazine (Trilafon) related to development of extrapyramidal side effects.

Thirteen acute psychotic patients received continuous oral treatment with perphenazine for a period of 8 weeks. Blood samples for quantification of perphenazine, perphenazine sulphoxide and prolactin were drawn twice weekly. Simultaneously, the therapeutic outcome and the degree of extrapyramidal side effects were recorded. The following conclusions were made: 1. In accordance with results achieved in one of our earlier investigations, a high risk of provoking extrapyramidal side effects was associated with plasma levels of perphenazine exceeding about 3 nmol/l. 2. An excellent therapeutic outcome was associated with plasma concentrations of perphenazine above 1.5 nmol/l. 3. Plasma concentrations of perphenazine and prolactin were poorly correlated to each other (R = 0.49). 4. A significant correlation (R = 0.85) was shown between the scores for the Brief Psychiatric Rating Scale and the Comprehensive Psychopathological Rating Scale.

Adolescent↗

Cimetidine clearance and bioavailability in hepatic cirrhosis.

Nine patients with compensated alcoholic and nonalcoholic cirrhosis of the liver and 11 patients with peptic ulcer received 200 mg of cimetidine orally and intravenously. No differences were observed in cimetidine clearance between the group with peptic ulcer (556 +/- 44 ml/min, mean +/- SEM) and the group with cirrhosis (606 +/- 64 ml/min). The bioavailability of cimetidine was unchanged (84 +/- 4% and 97 +/- 7%). In the patients with cirrhosis, cimetidine clearance did not correlate with galactose elimination capacity or antipyrine clearance. Cimetidine clearance was related to creatinine clearance only when both groups were considered. A reduction of cimetidine dose in patients with compensated cirrhosis appears unwarranted.

Administration, Oral↗

Saliva secretion following long-term antidepressant treatment with nortriptyline controlled by plasma levels.

Eight patients undergoing antidepressant therapy with nortriptyline for 1--4 years were investigated. The period of the investigation was 7 weeks and included a 2-week placebo period, blind for the patients. Total saliva secretion measurement, the nortriptyline plasma level, and signs and symptoms of depression and side effects were obtained once a week during the study. The results of the investigation were: (1) long-term treatment with nortriptyline is followed by hyposecretion or xerostomia, (2) the reduction of the secretion is reversible, (3) re-establishment of treatment with dosage leading to the same serum level of nortriptyline is immediately followed by a drop in saliva secretion, and (4) the changes in salivary secretion are useful as an indicator of side effects. The practical importance of the investigation is discussed.

Aged↗