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Biomedical subjects

R Erwald

Publications and source records attributed to R Erwald.

At least 19 recordsLinked to original sources
PubMed1989

Gallbladder carcinoma. Diagnostic procedures with emphasis on ultrasound diagnosis.

Gallbladder carcinoma is a highly malignant disease occurring with increasing frequency in Sweden. Early diagnosis influences the prognosis favourably. A series of 20 patients suffering from gallbladder carcinoma, was analyzed in search of criteria for early diagnosis. Among the imaging modalities, not only ultrasonography (US) but also oral cholecystography were found to provide important information. A plan for investigation and treatment of suspected gallbladder malignancy is proposed.

Adult↗
PubMed1986

Diet and pancreatic cancer: a case-control study.

In a population-based case-control study carried out in Sweden in 1982-1984, the authors examined the association of pancreatic cancer with several dietary factors, coffee, alcohol, and tobacco. Analyses were based on 99 cases, 138 population controls, and 163 hospital controls. The cases were persons aged 40-79 years diagnosed with cancer of the exocrine pancreas at three surgical departments in Stockholm and Uppsala. The risk increased with higher consumption frequency of fried and grilled meat in the comparison with each series of controls (e.g., relative risk (RR) = 1.7 (90% confidence interval (CI) = 1.1-2.7) for weekly intake and RR = 13.4 (90% CI = 2.4-74.7) for almost daily intake, in the comparison with population controls). Furthermore, associations were found with other fried or grilled foods, but not with meat other than fried or grilled. The risk also increased with the intake of margarine (e.g., RR = 9.7 (90% CI = 3.1-30.2) for 15+ g of margarine on a slice of bread, in the comparison with population controls). In contrast, no excess risk was associated with high intake of butter. A low risk was associated with frequent consumption of fruits and vegetables, particularly carrots (RR = 0.3 (90% CI = 0.2-0.7)) and citrus fruits (RR = 0.5 (90% CI = 0.3-0.9)) for almost daily intake. No consistent associations were found with coffee, artificial sweeteners or alcohol consumption, but a threefold increase in risk was associated with smoking at least one pack of cigarettes per day.

Adult↗
PubMed1986

Occupational factors and pancreatic cancer.

The relation between occupational factors and pancreatic cancer has been studied by two different approaches: a population based case-control study with two series of controls and a retrospective cohort study based on register data. With both approaches, some support was found for an association with occupational exposure to petroleum products. Associations were also indicated with exposure to paint thinner (case-control study) and work in painting and in paint and varnish factories (cohort study), for exposure to detergents, floor cleaning agents, or polish (case-control study) and with floor polishing or window cleaning (cohort study), and for exposure to refuse (case-control study) and work in refuse disposal plants (cohort study).

Adult↗
PubMed1984

Gardner's syndrome with adenoma of the common bile duct. A case report.

A family with Gardner's syndrome (GS) is presented. One family member suffered from adenomatosis of the stomach and the duodenum and bile duct obstruction due to adenoma of the common bile duct, and another died at the age of 24 in brain tumour. The various gastrointestinal manifestations of GS are discussed, the question being whether there is a difference between familial polyposis coli (FPC) and GS or not.

Adenoma↗
PubMed1984

Morphine glucuronidation in the rhesus monkey: a comparative in vivo and in vitro study.

The kinetics of morphine in the rhesus monkey after i.v. or oral administration including the hepatic extraction ratio determined directly in the portal and hepatic veins were compared with the glucuronidation of morphine in liver microsomes from the same animals. The plasma half-lives varied between 102 and 202 min and the apparent volume of distribution was 2.68 to 3.15 l X kg b.wt.-1. The systemic blood clearance (9.2-21.3 ml X min-1 X kg b.wt.-1) was in the same range as the estimated hepatic blood clearance (9.7-23.9 ml X min-1 X kg b.wt.-1). After i.v. administration, the blood concentrations of morphine-3-glucuronide ( M3G ) were 8 to 11 times higher than those of morphine. The molar blood concentration ratio between morphine-6-glucuronide and M3G was 0.04 or less. The ratio between the metabolite levels in blood was similar to the relative formation rates for M3G and morphine-6-glucuronide in liver microsomal preparations (less than .039). The intrinsic hepatic metabolic clearance of morphine as estimated from the apparent enzyme kinetic constants Vmax and Km for the formation of the major M3G metabolite was used to predict the hepatic extraction ratio. The predicted values of the hepatic extraction ratio (0.09-0.14) were, however, underestimates of the experimentally determined hepatic extraction ratio, which varied between 0.61 and 0.74. This indicates that unknown factors in the liver microsomal glucuronidation preclude the use of enzyme kinetics parameters obtained in vitro for the prediction of the hepatic extraction ratio of morphine. For some drugs that are oxidized it has been shown previously that such prediction from in vitro data is possible.

Animals↗
PubMed1977

Effect of vasopressin on the mixing of portal venous blood in awake man.

Transumbilical portal venous catheterization was performed in 11 patients for diagnostic selective portography. By use of a multiple-catheter technique, the effects of intravenous infusion of [8-lysine]vasopressin on portal venous mixing of tributary flows was measured by simultaneous blood sampling from the left and right portal branch, taking advantage of the oxygen saturation difference between splenic and superior mesenteric venous blood and also by infusion of 133Xe into one of the portal tributaries. Slight signs of incomplete portal mixing were observed at rest in eight of nine patients. During vasopressin infusion, the heterogeneity of oxygen saturation and xenon activity in the portal branches increased significantly. There was also a significant average shift of splenic venous blood toward the left portal branch with, in some patients, only splenic blood in this branch. Streamlining thus was a dynamic phenomenon related to the reduced and altered portal venous flow pattern. This must be considered during flow measurements, and might also have pathophysiological significance in liver diseases.

Adult↗
PubMed1976

Immunoreactive insulin in portal and hepatic venous blood in patients with insuloma.

The insulin level has been determined simultaneously in portal and hepatic venous blood in four patients with insuloma before and after administration of glucose and tolbutamide. Three patients displayed a higher insulin level in hepatic than in portal blood, although no hepatic metastases could be detected by radiologic examination. In contrast, portal insulin concentrations always exceeded hepatic in four control patients investigated in a similar way. The implications of these results are discussed.

Adenoma, Islet Cell↗
PubMed1976

Vasopressin tachyphylaxis. A study in conscious man.

The effects of repeated intravenous constant infusion of lysine-8-vasopressin (LVP) in a series of 12 conscious patients with portal venous catheters were studied. The portal venous pressure fell, the arterio-portal venous oxygen difference and the systolic and diastolic blood pressures rose and the heart rate decreased. Although no signs of tachyphylaxis were seen in portal venous pressure, systolic blood pressure or heart rate, they were observed both in the arterio-portal venous oxygen difference, indicating a tachyphylactic reaction in the effects on splanchnic blood flow, and in the diastolic blood pressure.

Aged↗
PubMed1976

Effect of vasopressin on regional splanchnic blood flows in conscious man.

In 11 conscious normovolaemic patients with acute or chronic pancreatitis the effect of a continuous intravenous infusion of lysine-8-vasopressin, 5 IU/70 kg b.w./20 min on the portal and the hepatic venous blood flows was studied by using multiple portal catheters, oxygen saturation measurements and an indicator dilution technique with continuous infusion of 133Xe into the portal vein or its tributaries. During vasopressin infusion the total hepatic blood flow, estimated by the Bradley technique with indocyanine green dye, was reduced to 61% of the value at rest. Owing to the simultaneously occurring streamlining of the portal venous flow with incomplete mixing of indicator and blood, the portal and hepatic venous blood flows could be measured in only 3 of 9 patients. The reduction in the portal venous blood flow during vasopressin infusion was more marked than the decrease of the total hepatic flow, corresponding to a calculated increase of the hepatic arterial flow of 50%. Total splanchnic oxygen uptake and extrahepatic splanchnic oxygen uptake were unchanged during and after infusion of vasopressin. Thus, changes in splandhnic blood flow could be estimated from changes in arteriovenous oxygen differences. Also by this method a more pronounced reduction in the portal venous than of the hepatic venous blood flow was observed. The decrease during vasopressin infusion of the superior mesenteric venous flow was more marked than that of the splenic vein. The splanchnic circulatory changes may be different for other doses of vasopressin and in cirrhotic patients with higher hepatic arterial blood flow fractions.

Acute Disease↗