Arne Nergårdh

Autonomic receptor function in the lower urinary tract of man and cat.

Autonomic receptor function was studied in vitro in smooth muscle strips from the lower urinary tract of children and cats. In strips from the dome of the bladder, cholinergic and β-adrenergic, but no α-adrenergic receptor function was demonstrated. In the bladder base as well as in the proximal urethra cholinergic and both α- and β-adrenergic receptors were found. This suggests that the sympathetic nervous system can subserve relaxation in the dome of the bladder and both contraction and relaxation in the bladder base as well as in the proximal urethra.

The Efficacy of Lamotrigine in Children and Adolescents with Refractory Generalized Epilepsy: A Randomized, Double-Blind, Crossover Study

Summary: Purpose: We report a double‐blind, placebo‐controlled crossover study of lamotrigine (LTG) as add‐on treatment in therapy‐resistant, generalized epilepsy in children and adolescents (n = 30).

Pharmacokinetic Interactions Between Lamotrigine and Other Antiepileptic Drugs in Children with Intractable Epilepsy

Summary: Purpose: We wished to determine the oral pharmacokinetics of lamotrigine LTG and to assess possible interactions with other AEDs in an unselected population of children. Concentration data in plasma and in CSF for lamotrigine as well as for the other AEDs are presented.

The effect of lamotrigine on epileptiform discharges in young patients with drug-resistant epilepsy.

Summary:  Purpose: In a double‐blind crossover study with lamotrigine (LTG), we investigated a possible relationship between the clinical responses and changes of the amount of epileptiform activity in EEG.

The Functional Role of Adrenergic Receptors in the Outlet Region of the Urinary Bladder: An in Vitro and in Vivo Study in the Cat

Adrencrgic receptor function has been studied in an in vitro preparation of bladder base, bladder neck and proximal urethra, i.e. in the outlet region. In this experimental sysiem changes in resistance to flow and isometric tension in longitudinal musculature could be recorded simultaneously when the preparation was continuously perfused at constant flow rate. It was found that the outflow region had a basal resistance to flow. Alpha-adrcnergic stimulation with metaoxedrine increased while beta-adrenergic stimulation with isoprenaline decreased flow resistance from this basic level. The beta-adrenergic reacticn was far more sensitive than the alpha-adrenergic one and was of longer duration. Similar results were obtained when adrenergic receptor function in the outflow region was studied in vivo in cats: it was then possible to activate and block the adrenergic receptors by the local application of drugs.

Influence of Atropine and Isoprenaline on Detrusor Hyperactivity in Children with Neurogenic Bladder

Bladder hyperactivity defined as unconscious, involuntary detrusor contractions giving rise to intravesical pressure increase of at least 15 cm H2O and of minimum 15 sec duration, has been examined in 9 children with myelodysplasia and incontinence. The effect of atropine and isoprenaline on the hyperactivity pattern was evaluated. Atropine had a dose-related inhibiting influence on both frequency and amplitude of detrusor contractions whereas isoprenaline was without these favourable effects.

The interaction between cholinergic and adrenergic receptor functions in the outlet region of the urinary bladder. An in vitro study in the cat.

The interaction between cholinergic and adrenergic receptor functions in the outlet region has been studied in vitro on preparations from cat bladder. Variations in resistance to perfusion were recorded, together with changes in the tension in longitudinal musculature. If the outlet region was contracted by continuous perfusion with alphn-adrenergic drugs it could be relaxed completely by intermittent beta-adrenergic stimulation. Cholinergic stimulation with acetylcholine also had a relaxing effect in this situation. On the other hand, if the outlet region was continuously relaxed with a beta-adrenergic stimulating drug, the flow resistance could be increased by alpha-adrenergic induced muscle activity and also by acelylcholine. Thus the adrenergic receptor functions appear to antagonize each other in the internal sphincter region, which is particularly sensitive to beta stimulation. The dual action of acetylcholine on flow resistance is probably due to its effect on the circular musculalure is mediated b...

Neurotransmission in activation of the contractile response in the human urinary bladder.

The endogenous contracting transmitter at the neuromuscular junction in strips from human urinary bladder has been investigated using field stimulation and selective antagonists. Atropine in low concentrations was found to inhibit bladder contractions whereas higher concentrations of the drug sometimes had the opposite effects. Indomethacin inhibited, phentolamine enhanced and methysergide had no dose-dependent effect on the field stimulation response. It is proposed that acetylcholine is one of the transmitter substances responsible for the contraction of the human detrusor. Species differences which could be responsible for the alleged atropine-resistance of the bladder are discussed. It is concluded that anticholinergic drugs should be of therapeutic value for treatment of muscular hyperactivity in the human urinary bladder.

Diagnosis of Detrusor Hyperactivity in Children with Neurogenic Bladder

Detrusor hyperactivity and its reproducibility was investigated in 22 patients with myelodysplasia and neurogenic bladder. The examinations were performed with microtransducers in the bladder, proximal urethra and rectum. Hyperactivity was found in 15 children all belonging to low lumbar and sacral neurological lesion groups. Patients without hyperactivity mostly had their levels of lesion higher in the spinal cord. In 6 children without neurologic disease no hyperactivity was found.

Reduction of Epileptiform Activity in Response to Low-Dose Clonazepam in Children with Epilepsy: A Randomized Double-Blind Study

Summary: Purpose: To evaluate the effect of low‐dose clonazepam (CZP) on the amount of epileptiform activity in children with focal and generalized epilepsy.