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Biomedical subjects

T Andersen

Publications and source records attributed to T Andersen.

At least 73 records · Page 4Linked to original sources
PubMed1987

Blood pressure and arm circumference during large weight reduction in normotensive and borderline hypertensive obese patients.

Blood pressure (BP) and arm circumference were measured in 44 normotensive and borderline hypertensive obese patients during treatment with either a very low calorie diet or diet supported with gastroplasty. The patients had reductions in sodium, energy, and carbohydrate intake. BP was determined with both a normal cuff (12-by-35 cm bladder) and a large cuff (15-by-43 cm bladder), using a random-zero sphygmomanometer. Both systolic and diastolic BP declined (p less than 0.005) (from 133 to 124 +/- 4 mmHg and from 87 to 81 +/- 3 mmHg (mean +/- SED), respectively), but reached a plateau after an average weight loss of 11 kg. No further reduction in BP was seen despite a maximal weight loss of 40 kg. At the same time arm circumference decreased from 36.4 to 30.5 cm. Moreover, the study showed that reductions in systolic and diastolic BP were closely associated with the pretreatment BP but not with the weight loss. The normal cuff overestimated the systolic BP by 8 +/- 4 mmHg and the diastolic BP by 6 +/- 3 mmHg (mean +/- SED) in patients with arm circumference of 35 cm and more.

Adult↗
PubMed1987

Impaired glucose-induced thermogenesis in skeletal muscle in obesity. The role of the sympathoadrenal system.

From a 7-day food recording in 29 morbidly obese patients two groups of six patients each were selected: a high-energy-intake group (HEI) and a low-energy-intake group (LEI). The groups were otherwise comparable. Five lean subjects served as controls for some observations. Oral glucose tolerance tests showed that all patients in the HEI group and the lean controls had normal glucose tolerance, whereas it was abnormal in all subjects in the LEI group. The fasting metabolic rate did not differ between the obese groups but was significantly lower in the lean group. The glucose-induced thermogenesis during 180 min expressed as a percentage of the energy content of the glucose load was lower in both obese groups compared with the lean controls (lean: +11.5 per cent, HEI: +5.3 per cent and LEI: -4.2 per cent, HEI vs lean: P = 0.04 and LEI vs lean: P = 0.005), and lower in the LEI group compared with the HEI group (P = 0.02). The integrated increase in leg oxygen consumption after glucose was also smaller in the LEI group than in the HEI group (15 +/- 269 vs 987 +/- 356 ml, P less than 0.05). The arterial noradrenaline response to glucose was significantly diminished in both obese groups compared with the lean controls. Glucose induced a similar increase in leg noradrenaline release in both obese groups, whereas the arterial adrenaline level was lower in the LEI group compared with the HEI group and with the lean controls (P = 0.04). Among the obese subjects the degree of glucose intolerance was inversely correlated with the post-glucose arterial adrenaline level (r = -0.55, and P = 0.04), and positively correlated with the fractional leg adrenaline extraction (r = 0.71, and P = 0.003). The results suggest that patients who are obese in spite of a fairly low energy intake have a reduced glucose-induced facultative thermogenesis, and that the defect is at least in part located in skeletal muscle. Since the sympathetic nervous system is partly responsible for the glucose-induced thermogenesis, the reduced thermogenic response in the obese patients may be due to an impaired activation of the sympathetic nervous system. It is hypothesized that the reduced arterial adrenaline level in the LEI group is caused by hyperglycaemic suppression of the adrenomedullary secretion and further that this may be a link connecting deterioration of glucose tolerance and a thermogenic defect in obesity.

Adrenal Glands↗
PubMed1986

Increased parathyroid hormone as a consequence of changed complex binding of plasma calcium in morbid obesity.

To evaluate whether changed plasma calcium binding might lead to a secondary increase of parathyroid hormone in morbid obesity, fasting measurements of serum ionized, ultrafiltrable and total calcium, calcium binding substances, and parathyroid hormone were undertaken in age- and sex-matched groups of obese (n = 44) and normal weight subjects (n = 52). The 24-hour urinary calcium excretion and clearance of creatine were also measured. Calcium binding to proteins was changed. Serum total proteins and protein-bound calcium did not differ, but serum albumin was decreased in obesity. Consequently, obese subjects did not reveal the normal dependency of protein-bound calcium upon albumin. Calcium binding to other substances was also changed. Serum phosphate and bicarbonate were decreased, while the concentrations of citrate, lactate, acetoacetate, 3-hydroxybutyrate, free fatty acids, and urate were all increased, leaving the total concentration of plasma complex-bound calcium unchanged. Nevertheless, these reciprocal changes increase the concentrations of less readily reabsorbable anions in the renal ultrafiltrate. The changed pattern of calcium binding in serum of the obese subjects may serve to explain our findings of increased urinary calcium excretion, lowering of serum ionized calcium and increased parathyroid hormone levels, changes being significantly correlated with degree of overweight.

Adult↗
PubMed1986

Intracranial glossopharyngeal schwannoma, a tumour imitating an acoustic schwannoma.

Neurinomas originating from the ninth cranial nerve are rarely observed. The early signs and symptoms of a glossopharyngeal neurinoma are rather discrete, and it can happen that a tumour here will often first be recognised with the signs and symptoms of an expanding posterior fossa lesion--thus often closely resembling an acousticus neurinoma.

Cranial Nerve Neoplasms↗
PubMed1986

The influence of insulin on the raised plasma fibronectin concentration in human obesity.

Plasma concentrations of fibronectin, free insulin, C-peptide and plasma glucose were determined in 40 morbidly obese subjects and in 51 normal weight controls, matched for sex and age. All plasma concentrations were significantly elevated (p less than 0.01) among the obese subjects. A significant correlation (r = 0.34, p less than 0.05) between plasma fibronectin and plasma free insulin was found among the obese patients, but not among the controls (r = -0.02, p greater than 0.05). No significant correlation was found between plasma fibronectin and plasma C-peptide, neither in the obese patients nor in the controls (obese r = 0.06, controls r = 0.02; p greater than 0.05). Plasma fibronectin was insignificantly correlated with body weight (obese r = 0.21, controls r = 0.15; p greater than 0.05) and percentage overweight (obese r = 0.27, controls r = 0.04; p greater than 0.05). The raised level of circulating insulin may in part explain the excess of plasma fibronectin obese subjects.

Adult↗
PubMed1986

Malakoplakia of the prostate causing fatal fistula to rectum. A case report.

A fatal case of malakoplakia of the prostate is described. The malakoplakia developed after 20 years of chronic prostatitis caused by E. coli and was not prevented by careful antibiotic treatment. Three years after the histological verification malakoplakia invasion caused fistula to rectum. Autopsy revealed no signs of any debilitating diseases.

Humans↗
PubMed1985

Effects of the extradural administration of local anaesthetic agents and morphine on the urinary excretion of cortisol, catecholamines and nitrogen following abdominal surgery.

Twenty patients undergoing major abdominal surgery were allocated randomly to receive either general anaesthesia with low-dose fentanyl plus intermittent systemic morphine for postoperative pain or the same general anaesthetic plus extradural analgesia during and following surgery (local anaesthetics from before skin incision until 24 h after skin incision plus extradural morphine 4 mg every 12 h from 3 h to 72 h after skin incision). Postoperative pain scores were lower (P less than 0.05) in the group receiving extradural analgesia, but this regimen failed to prevent the increase in the urinary excretion of cortisol, adrenaline, noradrenaline and nitrogen both on separate days and on cumulative measurements over 4 days. Pain scores did not correlate to urinary excretion of the various endocrine-metabolic indices either on separate days or over the cumulative 4-day period. It is concluded that the relief of pain per se has no major influence on the catabolic response to abdominal surgery.

Abdomen↗
PubMed1985

Obstetric risks in obesity. An analysis of the literature.

In order to evaluate the obstetric risks in obesity a partly computerized literature search was performed. Irrespective of language, papers published between 1960 and 1982 were included, provided that they were original and controlled studies on obstetric complications among women with a stated degree of overweight. Out of 143 publications 26 fulfilled the criteria and were included. They revealed information on 10,440 cases. Most reported subjects were only moderately obese. Thirty-seven complications were stated in one or more publications as being significantly more prevalent among obese women compared with lean controls. However, as data were often scarce or highly conflicting, it is concluded that an increased risk is only sufficiently documented with regard to a minority of these complications. They are: preeclampsia as well as each separate element of this disorder, diabetes mellitus, varicose veins, and the need for caesarean section. The significantly increased birth weight of the infants did not induce increase of labor complications.

Birth Weight↗
PubMed1985

The relationship between QTc changes and nutrition during weight loss after gastroplasty.

Electrocardiograms, serum electrolytes, plasma concentrations of pre-albumin and retinol-binding globulin, and dietary intakes were analyzed in 22 women during weight loss after gastroplasty surgery for morbid obesity. QT interval corrected for heart rate (QTc) was prolonged (greater than 0.44 sec) in 32% (95% confidence limits 14-55%) on one or more occasions. No clinical or electrocardiographic complications were seen. Occurrence of QTc prolongation was significantly (p less than 0.05) associated with protein intake below recommendation and with low plasma pre-albumin concentrations. QTc prolongation was not associated with mineral intake and occurred in spite of normal serum levels of calcium (uncorrected and albumin-corrected), magnesium, potassium and sodium. Because QTc prolongation may precede fatal arrhythmias, adequate protein intake is mandatory during weight reduction.

Adult↗
PubMed1985

A controlled study on the effect of epidural analgesia with local anaesthetics and morphine on morbidity after abdominal surgery.

A hundred patients scheduled for elective abdominal surgery were randomized to either general anaesthesia (low-dose fentanyl) and systemic morphine for postoperative pain or combined general anaesthesia and epidural analgesia with etidocaine 1.5% intraoperatively (T4-S5) and bupivacaine 0.5% 5 ml/4 h for 24 h and morphine 4 mg/12 h for 72 h. Postoperative pain was better controlled by the epidural regimen (P less than 0.0001). We found no significant reduction in postoperative mortality (6% to 2%), pneumonia (28% to 20%), cardiac dysrhythmia (10% to 5%) and wound complications (14% to 11%) by the epidural analgesic regimen. The incidence of deep venous thrombosis (125I-fibrinogen scan) was 32% after general anaesthesia and low-dose heparin and 34% after epidural analgesia with no prophylactic antithrombotic treatment (P greater than 0.9). Postoperative weight loss and decrease in serum-albumin and serum-transferrin, as well as the reduction in haemoglobin and the need for postoperative transfusions, were similar in the two groups. Convalescence, as assessed by postoperative fatigue, restoration of bowel function (flatus, bowel movement and food intake) and the time until the patients were self-aided at their preoperative level, was not reduced by epidural analgesia. Since 50% of the patients in each group suffered from one or more of the above-mentioned postoperative complications, this epidural regimen was not effective in reducing postoperative morbidity after major abdominal surgery despite the achievement of adequate pain relief.

Abdomen↗
PubMed1985

Pouch emptying of solid foods after gastroplasty for morbid obesity.

To obtain information on possible determinants of weight loss after horizontal gastroplasty, pouch emptying was prospectively investigated in 27 morbidly obese patients. A scintigraphic method was used. Examinations were carried out every 6 months until 2 years after surgery. Pouch emptying was described by means of delay, time until half emptying, mean transit time, and emptying rate. The measures all showed a significant (p less than 0.05) acceleration of pouch emptying during the first 6 months after gastroplasty. Thereafter pouch emptying was unaltered. No significant association could be detected between measures of pouch emptying and weight loss. From calculation of 95% confidence intervals for coefficients of correlation it proved very unlikely that pouch emptying is an important determinant of weight loss.

Adult↗