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Biomedical subjects

T Forslund

Publications and source records attributed to T Forslund.

At least 37 records · Page 2Linked to original sources
PubMed1992

[The endothelial cell as an endocrine organ--endothelin].

Endothelin is a newly discovered potent vasoconstrictive polypeptide released by endothelial cells in response to various stimuli, including vasoactive peptides such as angiotensin II, adrenaline and vasopressin, and thrombocyte products like transforming beta growth factor and thrombin. Endothelin is believed to exert its main effects locally, in a paracrine or autocrine way. In vascular tissue, endothelin induces longlasting contraction of smooth muscle cells, leading to decreased blood flow, especially in the coronary and renal circulation, together with an increase in systemic blood pressure. It acts also mitogenically in vascular smooth muscle cells. Endothelin stimulates release of aldosterone and catecholamines in non-vascular tissue, and inhibits release of renin. A physiological function of endothelin may be to modulate vascular tone, and increased levels of circulating endothelin are seen after the "cold pressor test". Moreover, plasma endothelin concentration is elevated during acute myocardial infarction, in acute renal failure, in patients with hypertension, and during cardiogenic chock. What role endothelin plays in the development of these conditions, and in other disorders such as vascular spasm and atherosclerosis is uncertain.

Endothelins↗
PubMed1992

Hormonal changes in patients with severe chronic congestive heart failure treated by ultrafiltration.

Plasma atrial natriuretic peptide (ANP), antidiuretic hormone (ADH), plasma renin activity (PRA), and circulatory haemodynamics were studied in five patients with chronic congestive heart failure undergoing ultrafiltration on two consecutive days. The patients were in the New York Heart Association class IV, and were considered candidates for heart transplantation. A mean of 3.3 +/- 0.5 litres of fluid was removed during each ultrafiltration. Plasma ANP concentration remained unchanged during ultrafiltration: 369 +/- 151 pg/ml at start and 316 +/- 116 pg/ml at the end, while plasma ADH concentration and PRA increased from 5.1 +/- 2.1 to 7.5 +/- 3.4 pg/ml (P less than 0.02), and 5.9 +/- 3.0 to 7.7 +/- 3.2 ng/ml (P less than 0.03) respectively (n = 10). After treatment, plasma ADH and PRA declined to baseline values within 1 h. Pulmonary artery, pulmonary capillary wedge, and right atrial pressures decreased significantly, while blood pressure and heart rate remained constant during ultrafiltration. A volume of 3.3 +/- 0.5 litres of fluid was removed, and caused an increase in colloid osmotic pressure from 22.0 +/- 3.0 to 33.7 +/- 3.9 mmHg (P less than 0.02). It was unexpected that plasma ANP concentration did not decline. Due to long-standing severe heart failure the atrial wall may have lost some of its elastic properties, resulting in less ability to adapt to reduced filling pressures. Accordingly, atrial wall stretch remained unchanged, explaining the constant ANP levels. Ultrafiltration treatment caused an increased responsiveness to diuretic therapy, and four patients survived long enough to receive heart transplants.

Adult↗
PubMed1992

Complications of nephropathia epidemica: three cases.

Haemorrhagic fever with renal syndrome (HFRS) in Scandinavia is called nephropathia epidemica (NE), and is caused by the Puumala-virus, which belongs to the Hanta-virus genus. The clinical course of NE is mostly benign, complications are uncommon, and deaths are rarely observed. We report the cases of three patients who developed serious complications in the course of NE caused by the Puumala-virus. One patient died within 24 h after admission, another developed progressive neuromuscular dysfunction (Guillain-Barré syndrome) which required auxiliary ventilation for several weeks before a slow recovery, and a third patient developed empty sella syndrome with pituitary gland insufficiency. In the first two cases the diagnosis of NE was confirmed by a rapid avidity assay for IgG antibody against Puumala-virus. In the third case the clinical course, and demonstration of NE immunity 16 years later, suggested that NE might have caused the hypopituitarism. Some patients with NE caused by the Puumala-virus may require intensive-care treatment, and the development of late complications such as empty sella syndrome and hypopituitarism should be taken into consideration.

Adult↗
PubMed1991

Cardiac tamponade due to ovarian carcinoma.

We describe a patient with ovarian carcinoma who presented with cardiac tamponade with subsequently development of cardiac arrest as the initial symptom. After successful resuscitation and pericardiocentesis our patient was given an intrapericardial infusion of bleomycin and there was no recurrence of pericardial effusion at 14 months follow-up.

Bleomycin↗
PubMed1991

Comparison of fosinopril and hydrochlorothiazide in patients with mild to moderate hypertension.

Seventeen patients with mild to moderate hypertension, as indicated by a diastolic blood pressure (DPB) of 95-115 mmHg (WHO I), were treated in a randomized, double-blind, parallel study, with either 5 mg of fosinopril, a new phosphinic acid-containing angiotensin converting enzyme (ACE) inhibitor, or 25 mg of hydrochlorothiazide administered orally once daily for 4 weeks after a 4- to 6-week run-in period of placebo. The doses were increased to 10 mg of fosinopril or 50 mg of hydrochlorothiazide if DBP remained above 95 mmHg. The blood pressure (BP) fell from 157 +/- 12/104 +/- 7 mmHg (mean value +/- SD) at the start of the study to 146 +/- 21/97 +/- 8 mmHg (P less than 0.02) after 4 weeks, and to 149 +/- 19/97 +/- 7 mmHg (P less than 0.02) after 8 weeks of fosinopril treatment (n = 8). In the hydrochlorothiazide-treated patients (n = 9), BP fell from 153 +/- 9/105 +/- 5 mmHg at the start of the study to 140 +/- 11/97 +/- 7 mmHg (P less than 0.01) after 4 weeks, and to 131 +/- 11/94 +/- 7 mmHg (P less than 0.01) after 8 weeks. After the first dose, DBP fell from 102 to 99 mmHg (NS) in fosinopril-treated patients, and from 105 to 96 mmHg (P less than 0.02) in hydrochlorothiazide-treated subjects. Serum active fosinoprilate concentration increased to 5.6 ng ml-1, 25.9 ng ml-1, and 43.8 ng ml-1 after 30, 60 and 120 min, respectively, and remained at a level of 6.6-7.7 ng ml-1 after 4 and 8 weeks, respectively. Serum ACE activity decreased from 21.6 +/- 11.0 mumol min-1 l-1 at the start to 9.3 +/- 13.7, 4.4 +/- 4.6, and 2.9 +/- 2.8 mumol min-1 l-1 after 30, 60 and 120 min, respectively. No side-effects and no changes in blood counts, electrolytes or kidney function were attributed to fosinopril during the study. Fosinopril is a safe, long-acting antihypertensive drug with a smooth onset of action. Hydrochlorothiazide treatment caused potassium loss and an increase in the levels of uric acid and triglycerides. Diastolic blood pressure decreased to the same extent as a result of treatment with either drug, while systolic blood pressure was better controlled by hydrochlorothiazide.

Adult↗
PubMed1989

Effects of licorice on plasma atrial natriuretic peptide in healthy volunteers.

Ingestion of licorice, 100 g daily for 8 weeks, caused a rise in 81% in plasma atrial natriuretic peptide (ANP) concentration in 12 healthy subjects. Mean body weight increment (1.6 kg) correlated with the increase in plasma ANP (r = 0.59; P less than 0.01). The plasma concentrations of antidiuretic hormone, aldosterone, and plasma renin activity decreased. All these hormonal effects, reflecting retention of sodium and fluid volume, were probably due to the known mineralocorticoid properties of licorice. Blood pressure increased transiently and two subjects developed reversible hypertension. The rise in plasma ANP concentration during ingestion of licorice may be considered a physiological response to prevent fluid retention and development of hypertension.

Adult↗
PubMed1988

Plasma atrial natriuretic peptide in cardiac transplant recipients. A prospective study.

Cardiac transplantation in 10 patients with congestive heart failure resulted in reduction of high plasma concentrations of atrial natriuretic peptide (ANP), preoperatively five-fold above normal, to a level two-fold above normal, which was maintained throughout a 12-week follow-up period. Cardiac function was normalized in all patients. Transient increases in plasma ANP, in four cardiac recipients 3-10-fold their basal levels, could neither be related to rejection episodes nor to cardiac dysfunction, but rather to signs of fluid and sodium retention. High plasma ANP levels in cardiac transplant recipients suggest that the capacity to secrete ANP is preserved in the transplanted heart.

Adolescent↗
PubMed1985

Primary amyloidosis with increased plasma carcinoembryonic antigen concentration. A case report.

A patient with suspected malignant disease had increased concentration of plasma carcinoembryonic antigen (CEA). Amyloidosis was demonstrated at autopsy. The amyloid fibril composition was characterized by immunohistochemical and immunochemical techniques and proved to be of the lambda light chain (AL) type. CEA was demonstrated in the liver parenchyma by using antihuman CEA antiserum. Increased plasma CEA concentration in a patient with primary amyloidosis has, to our knowledge, not been reported before.

Aged↗
PubMed1985

Renin-aldosterone axis in ethanol intoxication: effect of A II infusion.

Plasma renin activity (PRA) is increased while plasma aldosterone is not, during moderate ethanol intoxication. To elucidate mechanisms behind this dissociation of renin-aldosterone nexus, six healthy males were given angiotensin II (4 ng kg-1 min-1) by i.v. infusion following ingestion of ethanol (1.2 g kg-1 body weight). Prior to angiotensin II (A II) infusion, PRA rose and plasma aldosterone declined. A II infusion caused a roughly 3-fold increase of plasma aldosterone both in ethanol intoxication and in control experiments, and a transient suppression of PRA. Plasma renin substrate, cortisol, and angiotensin converting enzyme (ACE) remained unchanged. The decrease of serum potassium or the rise of Na+/K+ ratio in ethanol intoxication may explain the failure of the adrenal cortex to respond with aldosterone release to endogenous angiotensin II. However, the pressor dose of A II infused obviously overcame the blunting effect of ethanol on aldosterone release previously reported by us. Blood pressure, both diastolic and systolic, increased similarly during ethanol and control experiments in response to A II infusion, except in one subject, who during ethanol intoxication experienced a paradoxical fall in blood pressure while reacting normally to A II infusion without ethanol.

Adrenal Cortex↗
PubMed1984

Inhibitor binding assay of rat serum angiotensin converting enzyme.

Based on a specific binding of labelled inhibitor to the enzyme active centre, a new principle of enzyme assay, inhibitor binding assay (IBA), was developed and applied to measurement of rat serum angiotensin converting enzyme (ACE). Serum diluted 1:50 was incubated with 125I-labelled ACE inhibitor, 351A, at pH 7.0, 37 degrees C, for 2 h. Inhibitor bound to ACE was separated with coated charcoal and results were calculated from a standard curve. The advantages offered by the novel inhibitor binding assay include simplicity, specificity, absence of interference by other enzymes or immunological cross-reactions, and great sensitivity enabling measurement of ACE in concentrations less than 0.1 units/ml. This principle of enzyme assay will not only have potential new applications for research involving ACE but may also be extended to other enzymes.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed1984

A long-term follow-up of patients with essential hypertension treated with captopril.

Seventy-four patients from four short-term studies of captopril in mild-moderate essential hypertension continued in a cooperative long-term efficacy and tolerance program. The duration of observation is 2- greater than 4 years, the total treatment time being 2434 months. No development of resistance to therapy was observed. The total daily dose of captopril has been gradually decreased and in 20 patients changed from t.i.d. to b.i.d. regime. The drug has been well tolerated and only few and mild side-effects have been observed after the initial titration period. The drop-outs (n = 19) were mostly due to non-medical causes (n = 14). Except for one case of proteinuria, no laboratory abnormalities were detected and there were no signs of long-term toxicity.

Adult↗
PubMed1984

Tuberculosis of the colon in a kidney transplant patient.

A 58-year-old woman experienced recurrent fever episodes after kidney transplantation. She was treated with antibiotics because of suspicion of staphylococcus infection. Abdominal pain combined with haemorrhagic diarrhoea occurred eight months after transplantation. A barium enema revealed a stenotic process in the middle part of the ascending colon mimicking carcinoma, and hemicolectomy was consequently performed. Histological examination revealed tuberculosis with little granuloma formation and abundant acid-fast tubercle bacilli in the mucosa and submucosa, and only slight perigranulomatous reactions. The patient was successfully treated with triple antituberculous chemotherapy without deterioration of allograft function. Tuberculosis should be suspected in immunosuppressed patients suffering from pyrexia of unknown origin, even when chest X-ray is normal.

Colonic Diseases↗
PubMed1984

Tissue distribution of angiotensin converting enzyme in the rat: effect of captopril treatment.

Effect on different tissues with regard to angiotensin converting enzyme during captopril treatment in the rat was studied. Male Wistar-Kyoto rats (n = 9) were treated during four weeks with captopril dissolved into the drinking water at the dose 30 mg/kg/day. Control rats (n = 9) had water only. Serum angiotensin converting enzyme (ACE) activity increased three-fold during captopril treatment, and ACE of purified pulmonary plasma membranes increased about 64% (P less than 0.001) compared to untreated rats. ACE activity of membrane fractions of other tissues studied i.e. testicles, epididymes, kidneys, and small intestine brush border did not increase similarly during captopril treatment. The highest amounts of ACE was demonstrated in epididymes, but captopril did not produce increased amounts of ACE in the epididymes. The main source of increased serum ACE activity during captopril treatment appeared to be in the pulmonary tissue.

Animals↗
PubMed1984

Cardiac failure, hepatic congestion and increased level of serum carcinoembryonic antigen.

A 65-year-old woman undergoing chronic haemodialysis for chronic nephritis had transiently elevated serum carcinoembryonic antigen levels, up to 26 ng/ml for nearly 3 months. This elevation was most probably due to cardiac failure with hepatic congestion and pulmonary oedema, because the antigen level returned to normal when the cardiac failure was properly treated, and comprehensive examinations revealed no other cause. During follow-up for 18 months, the carcinoembryonic antigen level has remained normal.

Aged↗
PubMed1984

Two different primary lung malignancies after a successful kidney transplantation.

A patient with two histologically different primary pulmonary malignancies occurring simultaneously ten months after a successful cadaveric renal transplantation is reported. One tumor was an adenocarcinoma of the left lung and the other an oat cell carcinoma of the right lung. The differentiation of the two tumors was made by a fluorescein-conjugated antikeratin antibody staining technique. No tumor was present at the time of transplantation as judged from chest examinations. Ten months after transplantation a left-sided pleural effusion caused by the adenocarcinoma occurred simultaneously with a small infiltrate in the apex of the right lung. Simultaneous development of two histologically different lung tumors is unusual, and even more rare after renal transplantation.

Adenocarcinoma↗