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Biomedical subjects

N Graudal

Publications and source records attributed to N Graudal.

At least 19 recordsLinked to original sources

Atrial natriuretic peptide (ANP) in chronic obstructive pulmonary disease (COPD): the relationship between plasma ANP and lung function. Effects of exercise and of the calcium antagonist, isradipine, on plasma ANP. A randomised, double-blind, placebo-controlled study.

In patients with severe chronic obstructive pulmonary disease (COPD) an increased pulmonary arterial pressure (PAP), a raised plasma level of atrial natriuretic peptide (ANP) and a correlation between increasing PAP and increasing plasma ANP have been shown. Furthermore, a negative correlation between lung function and PAP has been reported, and calcium antagonists have been claimed to decrease PAP. The purpose of the present study was to investigate whether 1) a negative correlation between lung function and plasma ANP could be demonstrated, whether 2) plasma ANP would increase during exercise in patients with COPD, and whether (3), in a randomised, placebo-controlled, double-blind design, a calcium antagonist was able to decrease plasma ANP at rest and modify the expected increase in plasma ANP during exercise. Eighteen patients with severe COPD were investigated. Plasma ANP was measured at rest and during exercise before and two hours after ingestion of either a single dose of 5 mg of isradipine, or a single dose of placebo. At rest, a correlation between lung function (forced vital capacity) and plasma ANP was found (rho = -0.49, P = 0.05). During the first exercise period, before ingestion of isradipine or placebo, the median level of ANP increased from 74 pg/ml at rest to 97 pg/ml at exhaustion (P less than 0.0002) (all patients). Administration of isradipine did not alter resting levels or exercise induced increases in plasma ANP. It is concluded, that in patients with severe COPD plasma ANP tends to be higher the more severely FVC is reduced. Plasma ANP increases during exercise. The calcium antagonist, isradipine, does not alter resting levels or exercise induced levels of plasma ANP.

Atrial Natriuretic Factor

An HLA study in 74 Danish haemochromatosis patients and in 21 of their families.

HLA-A and -B alleles in 74 Danish patients and 21 homozygous relatives with idiopathic haemochromatosis (IH) were compared with those in a sample of 1719 chromosomes from healthy Danish control subjects. The following alleles occurred with higher frequencies in IH compared to controls: A3: 53.6% vs. 15.1% (Pc less than 0.001); B7: 33.1% vs. 15.6% (Pc less than 0.001); B14: 6.9% vs. 3.0% (Pc greater than 0.05); B38: 5% vs. 0.9% (Pc greater than 0.05); B47: 4.0% vs. 0.4% (Pc greater than 0.05). Pedigree analyses disclosed 19 different haplotypes in IH subjects, compared to 286 haplotypes in controls. The following haplotypes occurred with higher frequency in IH compared to controls: A3,B5: 10.3% vs. 0.3% (Pc less than 0.001); A3,B7: 25.6% vs. 6.6% (Pc = 0.001); A3,B14: 3.4% vs. 0.6% (Pc greater than 0.05); A3,B47: 6.9% vs. 0.2% (Pc greater than 0.05). The major IH marker HLA-A3 was found in 56% of the haplotypes. The patterns of HLA-alleles associated with IH in Denmark show similarities to those in Central Europe, Australia, USA and Canada, being A3,B7 dominated and those in Central Sweden, England and Ireland, being A3,B14 dominated.

Adolescent

The effect of the calcium antagonist, isradipine, on working capacity, pulmonary function, morbidity and survival rate in patients with severe chronic obstructive pulmonary disease (COPD): a randomized, double-blind, placebo-controlled study.

Beneficial effects of calcium antagonists on the pulmonary haemodynamics of patients with chronic obstructive pulmonary disease (COPD) have been observed in several studies. Such effects include a decrease in pulmonary vascular resistance, an increase in cardiac output, and an increase in oxygen delivery. The clinical implications of these effects are uncertain. The randomized, double-blind, placebo-controlled, long-term study described here is the first to investigate the clinical effects of a calcium antagonist on patients with COPD. The aim was to test the hypothesis that the calcium antagonist, isradipine, could increase working capacity and lung function, and decrease morbidity and mortality. Fifty-two patients with COPD were investigated. During a 22-month observation period no statistically significant differences between the isradipine group and the placebo group were found with regard to these parameters. It is concluded that the existing evidence does not justify the introduction of calcium antagonists as part of the routine treatment of COPD.

Aged

Characteristics of cirrhosis undiagnosed during life: a comparative analysis of 73 undiagnosed cases and 149 diagnosed cases of cirrhosis, detected in 4929 consecutive autopsies.

In 4929 consecutive autopsies performed during a period of 4 years, 222 cases (4.5%) of cirrhosis were found, of which 149 (3%) were detected while the patients were alive (diagnosed cirrhosis) and 73 (1.5%) were not detected while the patients were living (undiagnosed cirrhosis). Fifty-three of the 73 undiagnosed patients appeared to be completely without signs of cirrhosis (silent cirrhosis). In the diagnosed group, 70% of patients died from hepatic causes, in contrast to 16% in the undiagnosed group. At autopsy, the following complications of cirrhosis were found more frequently in the diagnosed group than in the undiagnosed group: ascites (41% vs. 8%), oesophageal varices (44% vs. 10%), splenomegaly (52% vs. 29%). The prevalence of hepatocellular carcinoma did not differ significantly in the two groups (12% vs. 8%). It is concluded that cirrhosis without obvious signs occurs relatively frequently, and that no sensitive non-invasive screening methods are available at present.

Adult

Erythropoietin in chronic obstructive pulmonary disease. Relationship between serum erythropoietin, blood hemoglobin and lung function--effect of the calcium antagonist isradipine on serum erythropoietin.

The relations between serum-erythropoietin (se-EPO), blood hemoglobin and lung function were investigated in patients with chronic obstructive pulmonary disease (COPD). In a randomized, double-blind, placebo-controlled design, the hypothesis was tested that se-EPO might increase after treatment with a calcium antagonist. In 18 patients with COPD, median se-EPO (19.2 mU ml-1) was in the low normal range. The correlations between se-EPO and blood hemoglobin (p = -0.63, p = 0.024) and between se-EPO and lung function indices were negative (n.s.) and the correlation between blood hemoglobin and lung function indices (n.s.) were positive. The hypothesis is proposed that the normal hemoglobin found in most patients with COPD is a result of a balance between a trend towards a decreased red cell mass, as found in chronic diseases, and a trend towards an increased red cell mass due to the erythropoietic effect of EPO. Se-EPO was not changed by the calcium antagonist, isradipine.

Aged

Family studies of hereditary hemochromatosis in Denmark and the Faroe Islands.

Pedigree studies were performed based on one Faroese and four Danish probands with overt idiopathic hemochromatosis (IH). The study consisted of HLA typing and determination of biochemical iron status indicators (serum transferrin saturation, serum ferritin). In total, 130 persons were evaluated. The screening identified 6 homozygous (h/h) subjects with preclinical IH, 46 heterozygous (h/n), and 8 normal (n/n) subjects, while 39 subjects were classified as normal or heterozygous (n/h?). One family demonstrated both a homozygous x heterozygous as well as a heterozygous x heterozygous mating. Recombination between the HLA region and IH locus occurred possibly in three subjects in three different families. The significance of detailed screening in families with probands with IH is discussed.

Adolescent

Serum ferritin and iron status in a population of 'healthy' 85-year-old individuals.

Iron status, including S-ferritin, S-iron, S-total iron binding capacity (TIBC), TIBC saturation, haemoglobin (Hb) and dietary iron intake, was assessed in a population study comprising 92 healthy 85-year-old subjects (32 males, 60 females). S-iron, S-TIBC, TIBC saturation and S-ferritin values were not significantly different in the two sexes. Males had a geometric mean S-ferritin of 130 micrograms/l, females of 98 micrograms/l. Ferritin levels less than 15 micrograms/l (i.e. depleted iron stores) were found in one female (1.6%); and in one male (3.1%), who in addition had iron deficiency anaemia. None of the females displayed latent iron deficiency (i.e. S-ferritin less than 15 micrograms/l and S-TIBC saturation less than 15%) or iron deficiency anaemia. Arithmetic mean Hb was 145 +/- 13 (SD) g/l (9.0 +/- 0.8 mmol/l) in males and 139 +/- 11 g/l (8.6 +/- 0.7 mmol/l) in females (p less than 0.02). Median nutritional iron intake was 10 mg/day (range 3-17), higher in males (median 12) than in females (median 9) (p less than 0.0001). Iron intake showed significant correlations to S-iron, S-TIBC and TIBC saturation, but not to S-ferritin.

Aged

[Fetal systolic time intervals. A non-invasive parameter for assessing the intrauterine condition of the fetus].

Various methods are employed in obstetric prophylaxis and treatment to assess the intrauterine condition of the foetus. The systolic time-intervals appear to be a promising new method because they reflect the contractility of the foetal heart which is a reflection of various physiological factors indluding hypoxia and asphyxia. Monitoring of the foetal systolic time intervals is therefore a more sensitive parameter of cardiac function than the foetal heart rate alone. By measurement of the foetal systolic time-intervals, it is therefore theoretically possible to evaluate the intrauterine situation of the foetus as abbreviated pre-exjection time (PEP) is a normal physiological reaction to scalp compressions, uterine contractions, or umbilical cord complications. Finally, the relationship between PEP and the ejection time (PEP/VET) is raised in asphyxia and greatly raised in imminent foetal death.

Female

Acute phase reactants in the elderly.

The erythrocyte sedimentation rate (ESR), plasma fibrinogen, serum orosomucoid, serum alpha 1-antitrypsin and serum haptoglobin were measured in 267 apparently healthy elderly subjects (median age 79 years, range 60-93), and compared to the values in 58 healthy younger subjects (median age 27 years, range 18-50). The acute phase reactants displayed no sex differences, but were significantly higher in elderly than in younger persons (mean +/- SD): ESR 13 +/- 10 mm/h vs 4 +/- 3 mm/h (p less than 0.001); fibrinogen 4.35 +/- 0.95 g/l vs 3.33 +/- 0.54 g/l (p less than 0.001); orosomucoid 0.68 +/- 0.20 g/l vs 0.60 +/- 0.16 g/l (p less than 0.01); alpha 1-antitrypsin 2.16 +/- 0.38 g/l vs 1.84 +/- 0.43 g/l (p less than 0.001); haptoglobin 1.30 +/- 0.50 g/l vs 1.00 +/- 0.30 g/l (p less than 0.001). Correlations existed between the acute phase reactants, being highest between ESR and fibrinogen (r = 0.53, p less than 0.001).

Acute-Phase Proteins

Alcoholic hepatitis in females.

In the period 1970-1984 alcoholic hepatitis was diagnosed by liver biopsy in 52 females. Thirty-six patients with cirrhosis were generally in a worse clinical and biochemical state than those without cirrhosis. Biochemical tests for liver function showed significant improvement from admission to the time of liver biopsy. At follow-up liver function tests were generally better in patients who had stopped drinking alcohol compared to those who continued to do so. The 5-year survival rate was 82% for females without cirrhosis, and 45% for those with cirrhosis (p less than 0.03). Considering the sex-related differences in alcohol abuse in the general population we found no evidence of increased susceptibility to the hepatotoxic effect of alcohol in females.

Adult

HLA determinants in 70 Danish patients with idiopathic haemochromatosis.

HLA-A, -B, -C and -DR antigens were determined in 70 unrelated Danish patients with idiopathic haemochromatosis. The frequencies of HLA-A and -B antigens compared to 1967 normal control subjects and the relative risk values (RR) were: A3, 80.0% vs. 26.9% (P less than 0.0001), RR = 10.9; B7, 60.0% vs. 26.8% (P less than 0.0001), RR = 4.1; B14, 10.0% vs. 4.5% (P = 0.03), RR = 2.4; B47, 4.3% vs. 0.5% (P less than 0.0001), RR = 9.7; A3, B7, 51.4% vs. 12.2% (P less than 0.0001), RR = 7.6; A3, B14, 10.0% vs. 1.4% (P less than 0.0001), RR = 7.7; A3, B47, 4.3% vs. 0.5% (P less than 0.0001), RR = 9.7. Six patients (8.6%) possessed none of these four typical antigens. There was no association between disease and the frequencies of HLA-C and HLA-DR antigens. The pattern of HLA-antigens associated with haemochromatosis in Denmark shows similarities to those reported both in Germany, being HLA-A3, B7 dominated, and in Brittany, Great Britain and Central Sweden, being HLA-A3, B14 dominated.

Adult