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Biomedical subjects

A Gustafsson

Publications and source records attributed to A Gustafsson.

At least 73 records · Page 4Linked to original sources
PubMed1998

Primary BK virus (BKV) infection due to possible BKV transmission during bone marrow transplantation is not the major cause of hemorrhagic cystitis in transplanted children.

In allogeneic bone marrow transplanted (BMT) patients BK virus (BKV) reactivation has been associated with haemorrhagic cystitis (HC). However, it is far from obvious which patients will develop HC, since BKV, a human polyomavirus, is ubiquitious and infects children at an early age. To investigate if a primary BKV infection, as such or possibly due to transmission of BKV by the marrow graft during BMT, was correlated to the development of HC, 45 children were followed for possible BKV seroconversion and development of HC at different time points after BMT. Serum samples were collected from the 45 allogeneic BMT children and their donors before transplantation, and from the patients at 3, 6 and 12 months after BMT. These sera were analysed for the presence of specific antibodies towards BKV by hemagglutination inhibition (HAI) and by IgG- and IgM-class specific enzyme linked immunosorbent (ELISA) assays. Twelve of the 45 BMT children had a documented episode of HC or hematuria. All patients and 98% of the donors were HAI positive before BMT, while with ELISA 87% of the patients and 84% of the donors were positive. Moreover, most HC and hematuria children (11/12) were seropositive with both assays before BMT, making it impossible to investigate possible BKV transmission through the bone marrow graft during BMT by serology. Still, serological changes such as ELISA seroconversion, IgM antibodies and/or HAI titer increases were significantly (p=0.016) more common in patients with HC (58%) than without HC (24%), but these changes occured mainly after HC symptomatology had already resolved. However, there was a near significant difference (p=0.053) in BKV seroprevalence by ELISA among the donors of patients with HC or hematuria (67%) as compared to the donors (91%) of patients without HC.

Adolescent↗
PubMed1998

Number and frequency of bitewing radiographs and assessment of approximal caries in 14-to-19-year-old Swedish adolescents.

The hypothesis of the present study was that previous experience of caries may serve as an indicator for individualised bitewing examinations in 15-19-old adolescents. One hundred adolescents, all 19 years old, were randomly selected from the files of public dental clinics in the County of Orebro. For 93 adolescents the total number of radiographs were summed for every patient from the age of 3 to 19 by assessing the files of public dental clinics and by assessing the files of the dental radiology department. All sets of bitewing radiographs from 14 up to and including the age of 19 were assessed with respect to approximal caries. The average number of intraoral radiographs exposed in a patient from the age of 3 through 19 was 24.4. It was shown that 70 to 80% of 14-19-year-old-adolescents had had a bitewing examination every year. The decision to perform a bite-wing examination in a 15-year-old was significantly correlated to the number of surfaces with initial caries at the age of 14. In the other age groups, none of the investigated variables was found to be significantly correlated to the performance of radiographic examinations.

Adolescent↗
PubMed1997

Optimization of 3D conformal electron beam therapy in inhomogeneous media by concomitant fluence and energy modulation.

The possibilities of using simultaneous fluence and energy modulation techniques in electron beam therapy to shape the dose distribution and almost eliminate the influences of tissue inhomogeneities have been investigated. By using a radiobiologically based optimization algorithm the radiobiological properties of the tissues can be taken into account when trying to find the best possible dose delivery. First water phantoms with differently shaped surfaces were used to study the effect of surface irregularities. We also studied water phantoms with internal inhomogeneities consisting of air or cortical bone. It was possible to improve substantially the dose distribution by fluence modulation in these cases. In addition to the fluence modulation the most suitable single electron energy in each case was also determined. Finally, the simultaneous use of several preselected electron beam energies was also tested, each with an individually optimized fluence profile. One to six electron energies were used, resulting in a slow improvement in complication-free cure with increasing number of beam energies. To apply these techniques to a more clinically relevant situation a post-operative breast cancer patient was studied. For simplicity this patient was treated with only one anterior beam portal to clearly illustrate the effect of inhomogeneities like bone and lung on the dose distribution. It is shown that by using fluence modulation the influence of dose inhomogeneities can be significantly reduced. When two or more electron beam energies with individually optimized fluence profiles are used the dose conformality to the internal target volume is further increased, particularly for targets with complex shapes.

Algorithms↗
PubMed1997

Markers of inflammation in crevicular fluid from peri-implant mucosa surrounding single crystal sapphire implants.

The 19 patients included in this study had all been successfully treated for total or partial edentulism with single crystal sapphire implants as retention for overdentures or fixed bridges. As there is a need for more reliable non-invasive parameters for detecting changes surrounding endosseous implants, the aim of this study was to assess the content and the activity of neutrophils in crevicular fluid samples from 3 categories of sites: (1) crevices around implants from edentulous patients (2) crevices around implants in partially edentulous patients, and (3) crevices surrounding teeth. Fluid samples were taken with paper strips from 9 partially edentulous and 10 edentulous patients and the volume measured with a Periotron 6000. Elastase activity was measured as a marker of neutrophil activity and lactoferrin concentration as a marker of the number of neutrophils. Elastase activity per microliter and lactoferrin concentration was, despite similar clinical and radiographic signs, significantly higher in samples from crevices surrounding teeth and implants in the partially edentulous patients compared to samples from crevices around implants in the totally edentulous patients. There were no differences between teeth and implants in partially edentulous patients. The increased elastase activity and lactoferrin concentration indicates a higher neutrophil activity in patients with remaining teeth.

Adult↗
PubMed1997

Gingival crevicular neutrophils: membrane molecules do not distinguish between periodontitis and gingivitis.

We have earlier reported hyperreactive peripheral neutrophils in adult periodontitis, measured as respiratory burst after Fc gamma receptor-mediated activation in vitro, but we have not been able to relate this increased activity to aberrations in the expression of relevant membrane molecules. Various types of inflammatory conditions involving the gingiva should affect membranes differently. We therefore collected crevicular neutrophils from three types of inflammatory sites: (i) with and (ii) without tissue destruction in the same periodontitis patients and (iii) inflamed sites in controls with gingivitis alone and compared the expression of membrane molecules by flow cytometry. The % of positively stained cells and their mean intensities of fluorescence (IFL) were similar in the three types of sites for CD15, CD11a, CD11b and CD16. Peripheral neutrophils studied with the same markers were not activated. This was verified by similar plasma concentrations of lactoferrin and L-selectins in the periodontal and control groups. Compared to peripheral cells, the crevicular neutrophils showed a significantly lower percentage of stained cells, while the stained cells increased their IFL. In conclusion, hyperreactive peripheral neutrophils in periodontitis show the same expression of membrane molecules after migration through different types of inflammatory lesions as do normal neutrophils in gingivitis.

Adult↗
PubMed1997

Priming response to inflammatory mediators in hyperreactive peripheral neutrophils from adult periodontitis.

OBJECTIVES: To study the response to in vitro priming of peripheral neutrophils from patients with periodontitis compared to healthy controls. Peripheral neutrophils from these patients had shown increased production of oxygen radicals after activation with opsonized bacteria and a difference in priming response could suggest an explanation for this hyperreactivity. MATERIALS AND METHODS: Peripheral neutrophils from a group of patients with periodontitis and from age- and sex-matched controls were preincubated with tumor necrosis factor alpha, lipopolysaccharide (LPS), formyl-methionyl-leucyl-phenylalanine and the tetra peptide arginyl-glycyl-aspartate-serine. After preincubation, the cells were activated with gammaglobulin opsonized-bacteria, i.e., a Fc gamma R-stimulation. The priming effect was assessed as the production of oxygen radicals and as the degranulation or primary granules. RESULTS: Showed that the patients had a slightly lower responsiveness to priming than had the controls. This difference in priming response was most pronounced when measured as degranulation of primary granules after preincubation with LPS and 20 min of activation. CONCLUSIONS: This study shows no difference in response to priming, with optimal concentrations of inflammatory mediators, between peripheral neutrophils from patients with adult periodontitis and healthy controls.

Adult↗
PubMed1997

Clostridium difficile associated with acute colitis in mature horses treated with antibiotics.

Clostridium (C.) difficile, or its cytoxin, was demonstrated in faecal samples from 10 of 25 (40%) mature horses investigated with acute colitis treated primarily with antibiotics for disorders other than diarrhoea. C. difficile was not found in faecal samples from 140 horses without signs of enteric disorders, from 21 nondiarrhoeic horses treated with antibiotics, nor from 22 horses with colitis untreated with antibiotics. Except for C. difficile neither Salmonella nor any other investigated intestinal pathogen was isolated in any of the diarrhoeic horses. The findings strongly support some earlier reports that C. difficile is associated with acute colitis in mature horses treated with antibiotics. Of the 10 horses, 4 proved positive for C. difficile both in culture and in the cytotoxin test, 4 in culture only and 2 only in the cytotoxin test. Eight of 10 horses positive for C. difficile were or had recently been hospitalised, indicating that C. difficile may be a nosocomial infection in horses. All horses positive for C. difficile were treated with beta-lactam antibiotics.

Acute Disease↗
PubMed1997

The association of erythromycin ethylsuccinate with acute colitis in horses in Sweden.

In Sweden there are several reports of mares developing acute colitis while their foals were being treated orally for Rhodococcus equi pneumonia with the combination of erythromycin and rifampicin. In this study 6 adult horses were given low oral dosages of these antibiotics, singly or in combination. Within 3 days post administration of erythromycin, in one case in combination with rifampicin, 2 horses developed severe colitis (one fatal). Clostridium difficile was isolated from one of the horses, whereas no specific pathogens were isolated from the other. Both horses had typical changes in blood parameters seen in acute colitis. Clostridium difficile was also isolated from the faeces of a third horse given an even lower dosage of erythromycin in combination with rifampicin. This horse developed very mild clinical symptoms and recovered spontaneously. In the fourth horse given erythromycin only, very high numbers of Clostridium perfringens were isolated. The horses given rifampicin only did not develop any clinical symptoms and there were no major changes in their faecal flora. In conclusion, it has been demonstrated that low dosages of erythromycin ethylsuccinate can induce severe colitis in horses associated with major changes of the intestinal microflora. Clostridium difficile has been demonstrated as a potential aetiological agent in antibiotic-induced acute colitis.

Actinomycetales Infections↗
PubMed1997

A systemic downregulation of gamma interferon production is associated with acute shigellosis.

Production of cytokines by peripheral blood mononuclear cells from Shigella-infected patients was assessed. The frequencies of tumor necrosis factor alpha (TNF-alpha), TNF-beta, and transforming growth factor beta mRNA-expressing cells were persistently upregulated during the course of shigellosis in comparison to those of healthy controls. In contrast, the frequency of gamma interferon (IFN-gamma) mRNA-expressing cells was significantly reduced during the acute stage compared to that during the convalescent stage and to that of healthy Bangladeshi controls (P < 0.01). Constitutive IFN-gamma production in Bangladeshi controls was significantly upregulated compared to that in Swedish controls.

Adult↗
PubMed1996

Priming of neutrophils with tumor necrosis factor-alpha measured as Fc gamma receptor-mediated respiratory burst correlates with increased complement receptor 3 membrane density.

Hyperactive or primed neutrophils which damage tissue via cytokines and membrane receptors may be implicated in the pathogenesis of inflammatory conditions. The purpose of this study was to elucidate the priming mechanism in neutrophils by assessing changes in membrane receptors and the Fc gamma R-mediated respiratory burst, measured as chemiluminescence. Purified neutrophilic granulocytes from healthy volunteers were preincubated with recombinant human tumor necrosis factor-alpha. This had a priming effect, increasing both the Fc gamma receptor-mediated luminol-enhanced chemiluminescence and the membrane expression of the C3bi receptor (CRB) (r = 0.843). The membrane densities of Fc gamma RII, Fc gamma RIII, and CR1 were unaffected by tumor necrosis factor-alpha. The mechanism of increased chemiluminescence may involve redistribution of the Fc gamma receptors and cooperation with upregulated CR3, facilitating crosslinking of the receptors. The experiments were performed in a buffer without divalent cations, since these increased the background activity and abolished the priming effect of tumor necrosis factor-alpha. In conclusion, a simultaneous increase in the Fc gamma R-mediated respiratory burst and CR3 density after priming with tumor necrosis factor-alpha indicates a cooperation between Fc gamma R and CR3.

Acetylglucosamine↗
PubMed1996

Nested PCR assays with novel primers yield greater sensitivity to Tanzanian HIV-1 samples than a commercial PCR detection kit.

To investigate the efficacy of the SK431/SK145 primer pair and two nested primer assays in amplifying African HIV-1 samples, a total of 35 Tanzanian PBMC samples were examined. These were assayed by two HIV-1 specific nested in-house PCR assays and a commercial HIV-1 PCR kit (GeneAmp) using SK431/SK145 as the primer pair. One of the nested PCR assays has been evaluated previously (old assay), whereas the modified assay was constructed from the HIV-1 sequence alignment released in August 1993. The modified nested primer assay showed increased sensitivity in the gag and env regions compared to the old nested primer assay. However, both the old and the modified nested primer assays displayed higher sensitivity for the detection of Tanzanian HIV-1 proviruses than the GeneAmp assay. When two regions were used (gag and env) as targets for the amplification, the modified nested primer assay detected 97.1% (34/35) of the proteinase K lysed samples, compared to 68.6% (24/35) using the SK431/SK145 primer pair (P < 0.01**). The results indicate that the SK431/SK145 primer pair may be less suitable when HIV-1 samples from Africa are analysed. The results also show that continuous modification of primer sequences can improve and maintain high sensitivity for the detection of highly divergent HIV-1 strains.

DNA Primers↗
PubMed1996

Increased release of free oxygen radicals from peripheral neutrophils in adult periodontitis after Fc delta-receptor stimulation.

The release of free oxygen radicals and degranulation was studied in neutrophils from 14 patients with adult periodontitis and 14 age- and sex-matched healthy controls. The neutrophils were activated by Fc gamma-receptor stimulation, using Staphylococcus aureus opsonized with gamma globulin. Release of oxygen radicals was measured as luminol-enhanced chemiluminescence. Degranulation was assessed as release of elastase, measured with a specific substrate and as release of lactoferrin measured with ELISA. The neutrophils from the patients showed a significantly higher chemiluminescence and a slightly higher release of elastase, whereas the release of lactoferrin was the same in both groups. In contrast, the ratio between the 2 degranulation products, elastase and lactoferrin, was significantly higher in the group with periodontitis. A flow cytometric analysis of the membrane expression of the adhesion molecules CD 11a, CD 11b, CD 15, CD 16, CD 35 and Mel 14 showed no differences in the median immunofluorescence between the 2 groups. This study showed a more than 2-fold higher release of free oxygen radicals from Fc-gamma-receptor stimulated neutrophils compared with healthy controls, which indicates a specific neutrophil-associated host response in adult periodontitis.

Adult↗
PubMed1996

Methodological considerations in GCF sampling with paper strips: poor recovery of uncomplexed elastase.

The purpose of this study was to assess the recovery of certain proteins from paper strips used for sampling of gingival crevicular fluid (GCF). During a period of 60 min, proteins were eluent in isotonic phosphate-buffered saline, pH 7.4, without detergent. This eluent did not lyse neutrophils applied to the strips, which might otherwise contribute intracellular substances-, e.g., elastase to the GCF samples. The proteins applied (MW 12-725 kD) were satisfactorily recovered (about 90%). However, free neutrophil elastase, unlike elastase complexed with alpha-2-macroglobulin, could not be recovered from the paper strips. Strips made of polyvinylidene difluoride (Durapore) were also tested and 31% of the applied pure elastase was recovered from them. A comparison of measurements made with a Periotron 6000 on Periopaper and Durapore strips, showed that the values obtained with Durapore were too low for accurate measurements of small volumes of fluid. On the whole, when the elution was made in isotonic buffers at neutral pH and without detergents, the recovery of most proteins was satisfactory and reproducible, and independent of MW in the tested range. However, the study also showed poor recovery of uncomplexed elastase.

Buffers↗
PubMed1996

Optimization of conformal electron beam therapy using energy- and fluence-modulated beams.

Fluence modulation of multiple electron beams of various energies has been used to optimize the delivered dose distribution during electron beam radiation therapy. By maximizing the probability of achieving tumor control without causing severe complications electron beam fluence profiles have been optimized for superficial target volumes. It is possible to use several equiportal fluence-modulated electron beams to modify the energy deposition with depth in a controlled manner making it possible to use the technique as an alternative to bolus. The technique was tested in two representative phantom geometries and in three clinical patient geometries using a set of five and two different energies. The local maxima in dose for the plans with five energies were typically lower than with the conventional or advanced bolus techniques. The principles for how the technique could be carried out in the future with a fourth generation radiotherapy accelerator are also indicated.

Electrons↗
PubMed1996

Hodgkin's disease.

This synthesis of the literature on radiotherapy for Hodgkin's Disease is based on 104 scientific articles, including 2 meta-analyses, 22 randomized studies, 5 prospective studies, and 58 retrospective studies. These studies involve 38,362 patients. The literature review clearly shows that radiotherapy is a cornerstone of treatment for localized Hodgkin's disease. At early stages, long-term survival is 80% to 90% when treatment is tailored to known prognostic factors. There is a tendency toward increased use of chemotherapy as additional treatment, however no evidence shows that it increases survival. To further improve survival following radiotherapy an attempt is being made to reduce long-term toxicity by better defining the patient groups who require lower radiation volumes, and delivering a dose that is as low as possible to avoid secondary solid tumors or delayed cardiopulmonary or gastrointestinal effects, while not jeopardizing therapeutic results. In advanced disease, radiotherapy may be needed as a complement to chemotherapy to effectively control bulky disease. For recurrent disease, radiotherapy may be considered as relapse treatment or additional therapy in conjunction with high-dose chemotherapy.

Combined Modality Therapy↗
PubMed1996

Non-Hodgkin's lymphomas (NHL).

This synthesis of the literature on radiotherapy for non-Hodgkin's lymphomas is based on 158 scientific articles, including 16 randomized studies, 18 prospective studies, and 90 retrospective studies. These studies involve 14,137 patients. Non-Hodgkin's lymphomas are highly radiosensitive, and local recurrence following radiotherapy is unusual. Radiotherapy probably cures approximately 50% of both low-grade and high-grade malignant NHL at stage I. Involved field is apparently sufficient, however, higher doses are required for high-grade malignant lymphomas. Chemotherapy is recommended for stage II. Consolidation radiotherapy after chemotherapy may increase the number of complete remissions. The value of adjuvant radiotherapy has not been confirmed. Radiotherapy plays a limited role at stages III and IV. Radiotherapy is clearly indicated for extranodal localized disease in the skin and in the orbit of the eye. It is important to identify groups and subgroups in whom radiotherapy alone is sufficient, ie, the risk for distant recurrence is small. MALT lymphoma belongs to this group. Radiotherapy is often valuable in palliative situations.

Combined Modality Therapy↗