Biomedical subjects
A Eriksson
Publications and source records attributed to A Eriksson.
Clinical characteristics of papillomavirus-vulvovaginitis. A new entity with oncogenic potential.
The purpose of this paper is to describe the clinical characteristics of HPV-vulvovaginitis. Clinical symptoms were recorded in 74 women with the diagnosis of papillomavirus vulvovaginitis. The diagnosis was established by colposcopic examination, immunological detection of viral structural antigen, and selected biopsies. Patient data were obtained from medical records and by interviews. Discharge, itching, burning, fissures and dyspareunia were typical symptoms. Discharge was more frequent in women with vaginal localization of the HPV infection, whereas itching and burning were the predominant complaint when the HPV lesions were present on the vulva. However, 14 women were asymptomatic. Thirty-nine women had atypical Pap smears. In half of these women, there was no evidence of intra-epithelial neoplasia. In 15 women with atypical Pap smears there was no clinical affection of the cervix uteri. But manifestations of wart virus infection in the vagina and/or vulva. Papillomavirus vulvovaginitis may be a subclinical infection, but many women suffer from distinct symptoms related to the location of the specific lesions. This infection of the vulva and vagina may be the sole cause of atypical Pap smears. The clinical recognition of this condition is a necessary prerequisite for a rational therapeutic approach.
Fatal arsenic poisoning--a case report.
A worker was buried under arsenic trioxide in an industrial accident. He was almost immediately released but had inhaled and swallowed substantial amounts of arsenic dust. In spite of intensive treatment, circulatory collapse could not be prevented, and he died 6 h after the exposure. The treatment, autopsy findings, and arsenic concentrations in tissues and body fluids are described and discussed.
Single drug polyestradiol phosphate therapy in prostatic cancer.
Serum concentrations of testosterone (T) and estradiol-17 beta (E2) were analyzed in prostatic cancer patients treated with 160, 240, or 320 mg polyestradiol phosphate (PEP) i.m. every fourth week as single drug therapy during a 6 month period. Estrogen effects on the liver were studied by analyzing serum levels of sex hormone binding globulin (SHBG) in the 320 mg group and compared with values obtained in patients treated with 80 mg PEP i.m. every fourth week + oral ethinylestradiol (EE2) 150 micrograms daily, or by orchidectomy. Orchidectomy levels of T were reached within 3 weeks in the 320 and 3 months in the 240 mg group. In the 160 mg group, mean T levels reached the upper limit of orchidectomy values after 6 months. Accumulation of E2 occurred to mean levels 1,300-2,500 pmol/L at 6 months. At 6 months, SHBG levels had increased to 617% of pretreatment values in the oral EE2 group, to 166% in the 320 mg group, and were unaffected by orchidectomy. No cardiovascular side effects occurred during single-drug PEP treatment.
[Castration as a better alternative to estrogen in the treatment of prostatic cancer].
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Human papillomavirus type 13 DNA in focal epithelial hyperplasia among Mexicans. Brief report.
Human papillomavirus (HPV) type 13 DNA was detected in focal epithelial hyperplasia lesions of the oral mucosa in seven half-caste mexicans. The lesions contained intracellular papillomavirus-like particles with a diameter of about 50 nm. DNA extracted from biopsies contained unintegrated HPV type 13 DNA genomes as revealed by Southern blot hybridization. The HPV 13 DNA that was isolated in the present study had the same restriction enzyme cleavage map as HPV 13 DNA, previously described by others. It was moreover confirmed that HPV type 13 genome is related to the genomes of HPV types 6 and 11.
Arterial bullet embolism with radiologic demonstration of vessel entrance site.
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Enzyme-histochemical differences in fibre-type between the human major and minor zygomatic and the first dorsal interosseus muscles.
Human masticatory muscles, innervated by the trigeminal nerve, differ in fibre-type composition from limb and trunk muscles, but the anterior and the posterior belly of the human digastric muscle, innervated by the trigeminal and facial nerves, respectively, do not. The major and minor zygomatic muscles from adult males, which originate from the second branchial arch and are supplied by the facial nerve, were analysed enzyme-histochemically and compared with the first dorsal interosseus hand muscle, which has spinal innervation and, like the masticatory and facial muscles, a large cortical representation. Both zygomatic muscles had a marked predominance of type II fibres, the minor one having the largest proportion (89.1 per cent) ever reported in human skeletal muscle. Besides type I, IIA, IIB, and a few type IIC fibres, there was a large group with an ATPase reaction at pH 4.6, between that of type IIA and type IIB, and termed IIAB. This fibre-type profile may reflect a special isomyosin composition. Type I and II fibres were of about equal diameter, corresponding to that of type I fibres in the masticatory muscles. Individual and intra-muscular variability in fibre size and shape was considerable. The unusually high frequency of type II fibres in the zygomatic muscles suggest that they have fast-contraction properties and relatively large motor units, and therefore are poorly adapted to finely-graded movements. The absence of muscle spindles supports this view. The hand muscle had a chequer-board pattern of type I, IIA and IIB fibres, similar to that of large limb and trunk muscles, with no difference between its two heads.(ABSTRACT TRUNCATED AT 250 WORDS)
Fatal firearm accidents in Sweden.
According to Swedish law, it is prohibited to possess and use firearms without a special permission (license), which is given only after a detailed personal investigation. This restrictive legislation accounts for the fact that deaths due to firearms in Sweden are rare in an international comparison. The number of accidental firearm fatalities in Sweden is 0.074/100,000 living persons. We have previously published a series of accidental firearm fatalities during hunting, and now we present an investigation on the non-hunting fatalities. The mean age of the victims was 27 years, and males predominated. Handguns, military rifles, and shotguns caused most of the accidents. The first published case of fatal thoracic airgun wound is also included. Slightly more than half of the accidents were caused by another person and were inflicted at close range. Unsafe handling of the guns, especially "playing" with the gun or during military training caused most of the accidents. It is doubtful that one could further decrease the low number of fatal firearm accidents in Sweden by even more restrictive legislation. Instead, it is concluded that the most important factor to stress is the safer handling of weapons.
Accidental firearm fatalities during hunting.
Swedish legislation concerning firearms is highly restrictive. It is illegal to possess weapons (except airguns) without a license. From 1970 through 1982, there were 79 accidental firearm fatalities in Sweden. This number, corresponding to 0.074/100,000/year, is very low in comparison with similar statistics worldwide. Of these fatalities, 47 were associated with hunting and were studied carefully. Despite an increase in both the popularity of hunting and in licensing of weapons, on change in the number of accidents per year could be confirmed. Twenty-nine accidents occurred during small game hunting, of which 24 involved shotguns, and 18 occurred during moose hunting. The mean age overall was 46 years. All victims and shooters were men. Most accidents occurred before noon and during the autumn. During moose hunting, the victim most commonly was either mistaken for game or was standing beyond game. During small game hunting, the most common reason for death was improper handling of the weapon. Firing of defective weapons caused at least 10 fatal accidents. Alcohol inebriation was uncommon. It is unlikely that more restrictive firearm legislation would further decrease the number of fatal accidents. Instead, we believe that accidental firearm fatalities during hunting can be prevented by safer and more careful handling of weapons, including unloading weapons before transporting them; by replacing older weapons with more modern and safer ones; and by not allowing children to handle weapons. No shots should be fired until it is clarified that the target really is a game animal, and when hunting with rifles, the fields of fire should be clarified beforehand. Shooters at stand must be instructed not to leave their stands until explicitly told to do so.
Rolled up to death. An unusual autoerotic fatality.
Recently, an unusual case of autoerotic death in which a man died of hypoxia after having enclosed himself in plastic was reported in this Journal (1). We present a second case showing many similarities to the one published previously.
Orchidectomy or oestrogen treatment in prostatic cancer: effects on serum levels of adrenal androgens and related steroids.
Peripheral serum levels of dehydroepiandrosterone (DHA) and its sulphate (DHAS), 4-androstene-3, 17-dione (A-4), 17 alpha-hydroxyprogesterone (17-OHP), cortisol and albumin were measured in patients with prostatic cancer before treatment and after orchidectomy or during combined oral and intramuscular oestrogen treatment. Orchidectomy caused a pronounced decrease in 17-OHP levels and minor but significant decreases in the levels of A-4 and DHAS. Dehydroepiandrosterone, cortisol and albumin were unaffected by treatment. Oestrogen treatment caused a pronounced decrease in the serum levels of DHA, DHAS, 17-OHP and A-4 and a small but significant decrease in serum albumin. Cortisol levels increased, probably due to elevated transcortin levels. The ratio of DHA to DHAS was unaffected by either orchidectomy or by oestrogen treatment. These results confirm that the testis contributes to circulating DHAS. The mechanism behind the more pronounced decrease in adrenal androgens during oestrogen treatment is not known but, for DHAS, increased metabolic clearance due to the decrease in albumin levels may contribute in this respect. The unchanged values for the ratio of DHA to DHAS indicate that this sex-specific sulphatase/sulphotransferase balance is insensitive to endocrine manipulations in adult men. The results further invalidate the hypothesis that there is a 'compensatory' increase in adrenal androgen output following orchidectomy.
Choroideremia: close linkage to DXYS1 and DXYS12 demonstrated by segregation analysis and historical-genealogical evidence.
Linkage studies using restriction fragment length polymorphisms were conducted in the X-linked disorder, choroideremia, designated TCD for Progressive Tapeto-Choroidal Dystrophy. Previously demonstrated close linkage with locus DXYS1 was confirmed (lod 11.44 at 0 recombination distance). In addition, locus DXYS12 was found to be closely linked with TCD (lod 3.31 at 0 recombination distance). The disease mainly occurs in three large kindreds in remote Northern Finland. While formal genealogical proof is lacking, all presently living (more than 80 affected males and 120 carrier females) probably originate from a common founder couple born in 1644 and 1646, twelve generations ago. All 36 patients and 48 carriers tested from the three kindreds had the same haplotype (TCD/DXYS1, 11kb/DXYS12, 1.6kb). Given that at least 105 female meioses transmitting TCD have occurred since 1650 in these kindreds, extremely close linkage between TCD, DXYS1 and DXYS12 is suggested. The above haplotype is a very useful diagnostic tool in these TCD families. We suggest that our historical-genealogical approach to linkage analysis may be possible elsewhere in similar isolated populations.
Reindeer papillomavirus transforming properties correlate with a highly conserved E5 region.
A papillomavirus was isolated from the epithelial layer of a cutaneous fibropapilloma on a Swedish reindeer (Rangifer tarandus). Reindeer papillomavirus (RPV) is morphologically indistinguishable from other papillomaviruses, but the restriction enzyme cleavage pattern of its genome is different. No sequence homology was detected between RPV DNA and the DNAs of bovine papillomavirus type 1 (BPV-1) and avian papillomavirus when hybridization was performed under stringent conditions. However, the RPV genome hybridized to the genome of the European elk papillomavirus and the deer papillomavirus under stringent conditions. A physical map of the RPV genome was constructed, and selected regions of the genome, covering the open translational reading frame (ORF) E5 and part of the E1 and L1 ORFs, were studied by nucleotide sequence analysis. The results made it possible to align the RPV genome with the genome of BPV-1. The E5 ORF of RPV has the potential to encode a 44-amino-acid, exceptionally hydrophobic polypeptide which is very similar to the E5 polypeptides of BPV-1 and deer and European elk papillomaviruses. RPV is oncogenic for hamsters and transforms C127 mouse cells in vitro. Several virus-specific mRNAs were detected in RPV-transformed C127 cells.
Serum prolactin assays have no prognostic value in treatment of prostatic cancer by orchidectomy or estrogens.
Eighty patients (54-75 years) with cytologically and/or histologically confirmed cancer of the prostate (CAP) were randomly allocated to either orchidectomy (ORX, n = 41) or combined intramuscular and oral estrogen treatment (ESTR, n = 39). Serum levels of prolactin (PRL) were determined prior to treatment and 6, 12 and 24 months after initiation of the treatment. In the ORX group, 32 patients responded to the treatment and 9 did not. In the ESTR group, 27 patients responded and 12 did not. Serum PRL levels were significantly increased by ESTR treatment in responders as well as in nonresponders, but were not affected by ORX. There were no differences in PRL values between responders and nonresponders at any time in any of the two treatment groups. It is concluded that serum PRL assays have no prognostic value in the employed endocrine treatment of CAP.
Differentiation of cardiac amyloidosis and hypertrophic cardiomyopathy. A comparison of familial amyloidosis with polyneuropathy and hypertrophic cardiomyopathy by electrocardiography and echocardiography.
The clinical and echocardiographic features of cardiac amyloidosis may closely resemble those of hypertrophic cardiomyopathy, and the disorders may thus be mixed up. The present study was undertaken in an attempt to identify features separating the two conditions by analysis of electro- and echocardiographic findings in patients with familial amyloid polyneuropathy and hypertrophic cardiomyopathy. Twenty-nine patients with familial amyloidosis and 22 with hypertrophic cardiomyopathy were studied. Particular attention was given to the sum of the S wave in V1 and R wave in V5 or V6, the echocardiographic left ventricular mass and cross-sectional area, the presence or absence of asymmetrical septal thickening, granular and sparkling myocardial appearance, thickened heart valves, systolic anterior motion of the mitral valve, and pericardial effusion. A granular and sparkling appearance of the myocardium and thickened heart valves were found to be the best predictors of cardiac amyloidosis, while low QRS amplitudes in relation to echocardiographic left ventricular mass and a pericardial effusion seemed less important. The presence of systolic anterior movement of the mitral valve, a large left ventricular mass and a sum of S in V1 and R in V5 or V6 greater than 35 mm indicated hypertrophic cardiomyopathy. When the four strongest predictors (left ventricular mass, thickened heart valves, a granular sparkling myocardial appearance, and systolic anterior movement of the mitral valve) were used to reclassify the present patients, 28 of 29 amyloidosis patients and 21 of 22 patients with hypertrophic cardiomyopathy were correctly categorized. Noninvasive methods may thus be useful for detecting the myocardial infiltrative process, and cardiac amyloidosis may be confidently diagnosed by typical noninvasive findings together with histopathological documentation of amyloid in an organ other than the heart.
Natural death while driving.
Of sudden natural deaths while driving, 126 occurred during 1980 through 1985 in the northern half of Sweden. The mean age of the 69 car driver victims was 59 years, considerably higher than that of traumatic car deaths, and all but 2 were males. The mean age of 57 operators of other vehicles was 66 years, and of these, 6 were women. Seven car drivers were stricken during commercial employment. Most accidents occurred during daytime and the distribution of the weekdays was fairly even. Ischemic heart disease accounted for 112 deaths, and other cardiovascular diseases for an additional 9 deaths. Only 1/5 of the victims experienced previous symptoms of disease. Out of at least 31 other persons at risk in the car deaths, only 2 passengers suffered minor injuries. The trauma in the deceased was in most cases minor in both car and other vehicle deaths. Property damage was also minimal. At least 1/3 of the drivers were able to stop the car before becoming unconscious. In none of the car cases was alcohol detected in the blood, while alcohol was identified in at least 2 of the other vehicle victims. The findings here agree with previous studies that natural deaths at the wheel are fairly uncommon, and that the risk for other persons is not significant. The value of adequate postmortem examinations of drivers dying in traffic is stressed--natural deaths can otherwise be overlooked.
Activators and inhibitors of coagulation and fibrinolysis in patients with prostatic cancer treated with oestrogen or orchidectomy.
The treatment of prostatic cancer with oestrogen has been reported to be associated with cardiovascular side effects. Twenty patients with recently diagnosed prostatic cancer were randomly allocated to oestrogen therapy or orchidectomy. As compared to healthy age matched controls the patients with prostatic cancer had increased base-line levels of fibrinogen (5.2 +/- 1.9 g/l versus 3.7 +/- 1.0 g/l; p less than 0.002) and factor VIII:C (166 +/- 62% versus 110 +/- 29%; p less than 0.001). During oestrogen therapy factor VII increased from 99 +/- 22% to 150 +/- 47% (p less than 0.001), while the antithrombin III level fell from 93 +/- 10% to 81 +/- 13% (p less than 0.001). Both these changes are in the direction of a hypercoaguable state. Concomitantly plasminogen increased from 113 +/- 14% to 142 +/- 18% (p less than 0.001), urokinase inhibiting activity fell from 105 +/- 10% to 90 +/- 9% (p less than 0.001) and C1-esterase inhibitor fell from 110 +/- 17% to 86 +/- 22% (p less than 0.05) in the oestrogen therapy group. After orchidectomy there were no changes in the activators and inhibitors of coagulation and fibrinolysis studied as compared to base-line values. Furthermore the D dimer, a specific degradation product of crosslinked fibrin increased from a normal to a pathological value in 4 out of 8 tested patients after 6 weeks of oestrogen therapy, but in none out of 9 tested patients in the orchidectomy group. Briefly stated, patients with prostatic cancer treated with oestrogen have increased levels of factor VII, factor VIII:C and fibrinogen and a decreased level of antithrombin III.(ABSTRACT TRUNCATED AT 250 WORDS)