The effect of palm oil, lard, and puff-pastry margarine on postprandial lipid and hormone responses in normal-weight and obese young women.

Only a few studies have been published on the postprandial effects of different fatty acids in obese subjects. Therefore, the present study investigated the effects of three test meals containing palm oil (PO), lard (LD), or puff-pastry margarine (PPM), all normal dietary ingredients, on postprandial lipid and hormone responses in normal-weight and obese young women. The study was performed as a randomized, crossover design. The fats differed in the content of palmitic acid, stearic acid, and trans monounsaturated fatty acids allowing a dietary comparison of different 'solid' fatty acids. The obese women had significantly higher fasting concentrations and postprandial responses of plasma total triacylglycerol (TAG), chylomicron-TAG, and insulin compared with the normal-weight women but there was no significant difference in the postprandial responses between the three test meals. The obese women had fasting concentrations of leptin four times greater than the normal-weight women. There were no postprandial changes in the concentrations of leptin. The fasting concentrations of HDL-cholesterol were significantly lower in the obese women than in the normal-weight women, whereas there was no significant difference between the two groups in the concentrations of total cholesterol or LDL-cholesterol. These results provide evidence that obese women have exaggerated lipid and hormone responses compared with normal-weight women but the different contents of saturated and trans monounsaturated fatty acids provided by PO, LD, and PPM have no effect in either group.

[Euricterus. A European database on icterus with emphasis on the Danish contribution]. / Euricterus. En europaeisk icterusdatabase med fokus på den danske andel.

Clinical and biochemical data were collected prospectively from 8032 jaundiced patients to form a database as part of a EU-supported project on computer-aided diagnosis. Patients were recruited prospectively from centres in all EU-countries and some other countries as well. Five hundred and twenty-eight jaundiced patients were collected from four centres in Denmark. Alcoholic cirrhosis, acute alcoholic liver disease and malignancy of the pancreas or the biliary tract were more common in the Danish data base: 49% of cases in Denmark as compared to 30% of cases in the international database. Viral hepatitis was underrepresented in Denmark, 16% as compared to 23% in the international group. A crude Bayesian diagnostic programme on the total database with 17 diagnostic groups achieved 63% accuracy. For the 528 Danish cases the diagnostic accuracy was 64% when the European data base was used, whereas it increased to 81% when only the Danish data base was taken as basis for the calculations. In conclusion, we found a drop in diagnostic accuracy for the Danish patients when using the large European data base instead of the national one.

Analysis of equipotential lines as a basis for impedance imaging.

A mathematical two-dimensional phantom model has been implemented. With this it has been possible to calculate the equipotential line patterns in a homogeneous medium with inhomogeneous inclusions. The results have been compared with measurements in a physical phantom with identical outline. The shape of the phantom can be adapted to varying outlines congruent with transections of the human body. The physical measurements verify closely the pattern of the equipotential lines. Three approaches are suggested in applying the mathematical phantom model as a useful tool in impedance imaging.

Evaluation of applied potential tomography: a clinician's view.

There are several imaging techniques available to the clinician today. The clinical evaluation of a new method such as applied potential tomography (APT) raises a number of questions and these are reviewed in this paper. In particular, the advantages of APT over other methods are stressed. It is considered to be harmless both to the patient and the clinical staff, it is easy to apply and there is no discomfort to the patient during the imaging procedure. The main drawback of this new and inexpensive imaging method appears to be its low resolution. Several clinical applications of APT have already been investigated and others are anticipated in this paper. Each application is reviewed in some detail and the value of dynamic imaging is emphasised in several cases. The most promising clinical application of APT so far has been the monitoring of gastric emptying.

Acupuncture and transcutaneous electric nerve stimulation in the treatment of pain associated with chronic pancreatitis. A randomized study.

In 23 patients with pancreatitis, daily pain for at least 3 months, and no abuse of alcohol, the pain-relieving effect of electroacupuncture (13 patients) or transcutaneous electric nerve stimulation (TENS) (16 patients) was studied. In two prospective studies with a cross-over design, active acupuncture was compared with sham acupuncture, and TENS of the segmental points of the pancreas with sham treatment. Neither electroacupuncture nor TENS brought about pain relief that could substitute for or supplement medical treatment.

Computer modelling of haemodialysis/ultrafiltration explaining the pathogenesis of the disequilibrium syndrome.

Based on the hypothesis that rapid corrections of pH, Na+ and osmolality give rise to disequilibrium (DES) during efficient haemodialysis (HD), a 14 compartment model has been designed for dynamic analysis of the induced fluid shifts and the resulting haemodynamic reactions. Simulated HD and ultrafiltration (UF) on the model were based on data from 11 steady state dialysis (RDT) patients (diffusion coefficients for urea, body fluid compartments, haemodynamic monitoring by Swan-Ganz catheters). The model reactions correlated remarkably with clinical findings and indicate how far a patient's haemodynamic compensation can prevent circulatory collapse and hypovolaemia, mainly through lowering the mean pressure in a major portion of the capillaries. Steady weight dialysis causes reduction of blood volume up to 65 per cent before circulatory collapse occurs.

Hormonal response to volume depletion in non-nephrectomised patients on regular haemodialysis.

The hormonal response to volume depletion by isolated ultrafiltration has been studied in seven non-nephrectomised haemodialysis patients. The mean reduction in blood volume was 14%, and pulmonary artery wedge pressure reduction averaged 77%. No increments in heart rate were observed in any of the patients. Cardiac output decreased while systemic vascular resistance increased. Mean arterial blood pressure remained stable in all but two patients. Significant increments in plasma vasopressin concentration were only found during hypotensive episodes, while in the whole group no significant increase was found. Both plasma renin activity, plasma aldosterone and plasma cortisol increased significantly during isolated ultrafiltration. The moderate increase in systemic vascular resistance indicates that the peripheral sympathetic nervous system - at least partly - was functioning. It was, however, not correlated with changes in any of the measured hormones. Furthermore the adrenal and cardiac response appeared to be absent.

A new parallel plate dialyser. II. Description of design and in vitro performance.

Using a high efficiency membrane support pattern, described in the previous paper, a prototype of a new parallel plate dialyser has been developed. The new dialyser is designed in such a way that the number of components is reduced to one item per blood layer and the membrane is folded as a continuum. This permits a semiautomatic assembly of the unit, which reduces production costs. Furthermore this technique facilitates aseptic handling of the item. The in vitro performance has been tested and it compares favorably with commercially available disposable parallel plate dialysers.

A new parallel plate dialyser. III. Preliminary experience on clinical performance.

The clinical model of a new parallel plate dialyser with a membrane area of 0.96 m2 with cuprophane 150 PM has been tested in more than 2000 dialyses with good clinical results. The simple design permits an aseptic, semiautomatic assembly and makes cheap industrial production possible. Clinical clearance values for urea, creatinine and uric acid are presented as well as data for ultrafiltration, residual blood volume and rupture frequency. The specific efficiency per square meter has been found to be high.

A new parallel plate dialyser. I. Development and testing of membrane support.

The pattern of membrane support in the dialysate flow path of a dialyser is one of the most important parameters for high utlization of the membrane-area. 27 different injection moulded membrane support patterns were designed to approximate a pattern with the best overall properties. Only 15 of the patterns had acceptable properties in regard to 1) efficiency, 2) compliance, 3) flow resistance, 4) membrane rupture level, and 5) air retention at low flow values. A pattern with parallel interrupted ridges perpendicular to the direction of dialysate flow showed the best overall results although differences were marginal between the best patterns. The chosen support pattern was approximately 35% better in chloride clearance at low dialysate flow, and approximately 200% better at high flows than the conventional Kiil pattern.

Bacteriological and clinical evaluation of different dialysate delivery systems.

In the period 1964-74 four different dialysate delivery systems have been used in our department. 1) Central mixing of dialysate using tap water and a dialysate delivery line with "dead ends" resulting in stagnant dialysate. 2) Central mixing of dialysate with cold distilled water, otherwise equal to system 1. 3) Local mixing of dialysate with cold distilled water, delivered through a line with "dead ends" resulting in stagnant water. 4) Local mixing of dialysate with distilled water, cooled to 25 degrees C just prior to use, reduced "dead ends" and monitored constant overflow to drain through the water supply line. The bacterial contamination of the four systems was examined and related to the clinical occurrence of pyrogenic and other reactions. An improvement was noted with the change from central to local mixing of dialysate (system 3) but complete sterility and virtual freedom from clinical reactions were first obtained in system 4. It is concluded that the use of sterile or near sterile dialysate is recommendable.