Biomedical subjects
Publications and source records attributed to A Eriksson.
We describe a device for the simultaneous recording of the autopsy findings during the autopsy, thereby offering a convenient way of obtaining correct and timely autopsy reports.
A patient with Bence-Jones myeloma and amyloidosis was treated with cytotoxic drugs and plasmapheresis, resulting in rapid improvement of myeloma-associated symptoms and signs. However, amyloidosis-associated symptoms, especially hypotension, grew worse. Echocardiographic examination demonstrated hypertrophy and a hyperrefractile appearance of the myocardium, thought to be pathognomonic of amyloid heart disease. A permanent pacemaker was inserted for treatment of Adams-Stokes attacks caused by sick sinus syndrome and atrioventricular conduction disturbances. Postmortem examination of the heart demonstrated abundant amyloid deposits corresponding to the altered acoustic qualities of the myocardium. Echocardiographic examination is a valuable non-invasive method for demonstration of amyloid deposits in the heart in multiple myeloma.
Twelve patients with familial amyloidosis with polyneuropathy were examined both by cross sectional echocardiography and by technetium-99m pyrophosphate scintigraphy to assess involvement of the heart non-invasively. All 12 patients had echocardiographic abnormalities. The most prominent findings were highly refractile myocardial echoes, thickened heart valves, and increased thickness of the heart walls. Four patients had abnormal myocardial uptake of technetium-99m pyrophosphate. The remaining eight had equivocal or no myocardial uptake and were considered to have normal scintigrams. A certain amount of amyloid is probably required to produce an abnormal scintigram, although lesions with less amyloid can evidently be identified by echocardiography. Neither the duration of polyneuropathy nor its severity showed any relation to the echocardiographic or scintigraphic findings. It is concluded that cross sectional echocardiography is superior to technetium-99m pyrophosphate scintigraphy in detecting cardiac involvement in familial amyloidosis with polyneuropathy and that these results may also be applicable to other forms of amyloidosis.
A group of 16 patients received Class II restorations at two different sessions. During one session a dentist interacted positively with the patient. During another session, the dentist had little interaction with the patients. Patients' ratings indicated that both dentists were perceived as equally competent but that the dentist who interacted with the patients was rated significantly better. It is possible that dentists will gain more satisfaction from their patients as they increase their interaction.
The incidence of genital wart virus infection was estimated in 160 women with cervical cytologic atypia detected at routine screening. More than 70% of the women younger than 25 years had condylomata, as judged from colposcopy, histologic study and test for human papilloma virus antigen. Rational management of this sexually transmitted disease should include the male partner(s). Subclinical infection is common, and colposcopy is an important aid for its identification. 'Condylomatous vaginitis' may be a new entity which should be considered in women with cytologic atypia and/or diffuse vaginal symptoms.
A series of 51 fatal cases of accidental hypothermia in northern Sweden has been reviewed. The cases conform well to previous investigations with respect to the mean age of the victims (48 years) and a predominance of males. The cases occurred mainly during the winter months and on Saturdays. Most cases succumbed at temperatures below -10 degrees C. The most frequent necropsy findings were areas of frostbite with purple discoloration of the skin, reddish lividity and superficial erosions of the gastric mucosa. Paradoxical undressing was present in more than half of the cases. About two thirds of the cases were under the influence of alcohol with a mean blood alcohol concentration of 1.6 g/l. Furthermore, at least half of the cases could be considered habitual drunkards. In conclusion, the present series shows two main groups of fatal hypothermia victims: one group of elderly persons, mostly chronic abusers and under the influence of alcohol (approximately two-thirds of the series), and another of younger and sober persons, performing recognised sporting activities (approximately one-fourth of the series).
In a prospective study from northern Sweden, a series of 137 persons injured in snowmobiling accidents was analyzed. Most of the injured riders were males aged 10 to 39 years. Almost two-thirds of the accidents occurred at week-ends and the frequency was highest in the months of March and April. Three of four persons were injured during racing or leisure activities. The accidents most often involved sudden arrest of the snowmobile due to collision with an obstacle, or fall from the machine while driving it. The injuries were of major degree (MAIS greater than or equal to 2) in almost half of the cases and the lower extremities were the most commonly injured sites. In-patient care was required by 28% of the injured, for on average 11 days. Sickness insurance benefit was received by 64%, mean 48 days. The cost of treatment and sickness benefit averaged 8 000 SEK per case.
We report five cases of dysfunction of the sinus node in patients suffering from familial amyloidosis with polyneuropathy. The implantation of a pacemaker resulted in symptomatologic relief in all.
Cardiac conduction disturbances are frequent in amyloidosis with cardiac involvement, but the pathogenesis of these electrocardiographic abnormalities is not clear. In the present study, the conduction systems in six patients with the Swedish variety of familial amyloidosis with polyneuropathy (FAP), have been analyzed. The results suggest that in FAP, direct amyloid infiltration of the atrioventricular conduction system accounts for the majority of the electrocardiographic disturbances.
Autonomic nerve function was evaluated by deep breathing and tilt table tests in 17 patients with rheumatoid arthritis (RA) and in 24 healthy control subjects. The results showed that all RA patients had increased heart rates at rest, irrespective of the severity of the disease. Patients with severe RA had increased systolic and diastolic blood pressures before and after tilting. Pronounced abnormalities in the immediate heart rate reaction to tilting indicating autonomic neuropathy (AN) were also demonstrated in patients with severe RA. The abnormal immediate reaction to tilting was mainly the result of vagal neuropathy. From the present study it is evident that severe RA may be accompanied by AN and the consequences need to be elucidated.
We describe the case of a 10-year-old boy who had been admitted on several occasions with a diagnosis of gastroenteritis. He had been severely ill, and on one occasion lost consciousness. He had a metabolic acidosis on these occasions. Examination of the urine by gas chromatography-mass spectrometry showed a large peak, identified as glycerol. The concentration of glycerol in the urine was 40-280 mmol/L and the concentration in plasma about 2 mmol/L. He was subjected to a fast of 21 h, at the end of which he expressed feelings of discomfort and nausea, began vomiting, and became somnolent. During this period the blood glucose concentration was only slightly decreased, the plasma glycerol concentration increased to 4.9 mmol/L, and the plasma lactate concentration increased to 3.8 mmol/L. During work on a bicycle ergometer for 35 min (40 W) he complained of muscle pain and became nauseated, but there was no significant increase in the concentration of plasma glycerol. The activity of glycerol kinase (EC 2.7.1.30) in leukocytes and cultured fibroblasts was less than 1% of the value for healthy subjects.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Human testes contain trace amounts of heat-stable placental-like alkaline phosphatase. Using a recently described allotype-specific monoclonal antibody (F11) toward placental alkaline phosphatase (PLAP), we show that the frequencies of reactivity of the testis enzymes differ greatly from those of the placental phenotypes. By means of the enzyme inhibitors L-Phe, L-Phe-gly-gly, L-Leu, and L-Leu-gly-gly, the testis enzyme can be clearly distinguished in all cases from the placental enzyme. These results argue that the testis enzyme is not a product of the placental gene and suggest the possible existence of a new locus of alkaline phosphatase.
The intermediate filaments have during recent years increasingly attracted attention and new information on the distribution of the subunits of the filaments has become available by the use of specific antibodies. In the present study human fetal hearts at midgestation were studied with immunofluorescence microscopy for a demonstration of the intermediate filament subunit skeletin. In the ordinary ventricular and atrial myocytes the fluorescence was moderate, mainly concentrated to the Z disk levels. The proximal parts of the conduction system also showed a moderate fluorescence, while the fluorescence was intense in the cells in the peripheral parts. The shift from moderate to intense fluorescence occurred in the very proximal part of the left bundle branch and in the distal part of the intramural right bundle branch. We conclude that the conduction cells attain Purkinje fibre-like characteristics at these levels, as evidenced by the content of skeletin. Furthermore, the human fetal Purkinje fibres are more easily distinguished with the technique used herein than with conventional histological techniques. The observed differences in content of skeletin are discussed in terms of the cytoskeletal function of intermediate filaments and the embryology of the conduction system.
The histochemical muscle-fibre composition of the anterior and posterior belly of the human digastric muscle was analysed in young male adults. Both bellies, of differing embryological origin and supplied by different cranial nerves, showed a fibre composition similar to that of normal limb and trunk muscles. Type I, type IIA and type IIB fibres each occupied about one-third of the total fibre population and were evenly distributed in a mosaic pattern. About 1 per cent of fibres were type IIC and ATPase (pH 9.4) intermediate fibres. Thus, there were major differences between the anterior belly of digastric and the likewise trigeminal nerve innervated masticatory muscles with respect to both histochemical profile and size and distribution of various types of fibre. The observations suggest that the fibre pattern of the digastric is not primarily related to its specific nervous supply but its special functional demands. The predominance of type II fibres indicates a capacity for fast acceleration and speed in mandibular movements. The disparity in fibre-type profile between the digastric and the jaw elevator muscles might be related to changing demands during evolution. Civilized diets need no heavy mastication and, while the requirements upon the jaw elevators have thus changed, the functional demands on the jaw openers would have remained unchanged.
Explore the source record for details and available documents.