Biomedical subjects

B Bergman

Publications and source records attributed to B Bergman.

At least 19 recordsLinked to original sources

PubMed2002

Long-term clinical outcome of transurethral microwave thermotherapy (TUMT) 1991-1999 at Karolinska Hospital, Sweden.

OBJECTIVE: Minimal invasive methods, such as transurethral microwave thermotherapy (TUMT), are economical and have modest side effects compared with transurethral electro-resection of the prostate (TUR-P). The treatment results from different TUMT-systems vary. Follow-up studies on each system type are therefore necessary. The objectives of this study are to summon the long-term clinical results of our TUMT-system and search for a pre-treatment parameter that can measure responding patients. MATERIAL AND METHODS: Three hundred and seventy-one patients with benign prostate hyperplasia (BPH) were treated with TUMT at Karolinska Hospital, Sweden with the ECP-system (Comair AB, Stockholm), for 30 or 60 min. They were followed up 12 to 72 months after TUMT. RESULTS: At follow up approximately 76% subjectively judged that they had benefited from the treatment and 22% judged that they were fully cured. The over-all IPSS and Quality of Life score decreased approximately 40% and 30% respectively. Forty-one per cent of the patients with CAD (cathéter à demeure) before the treatment became permanently or temporarily catheter-free after the treatment. Q(max) increased 21% and 11% after 1 and 6 months respectively. Q(max) ranging from over 10 ml/s seem to be a selection parameter that increases the number of responding patients. CONCLUSION: These long-term clinical data show that TUMT treatment with ECP (electro-coagulation, prostate), gives a good success-rate, with reduction of symptoms. Furthermore there is a good chance of becoming catheter-free after TUMT.

Aged↗

PubMed2002

Characterization of Trichodesmium spp. by genetic techniques.

The genetic diversity of Trichodesmium spp. from natural populations (off Bermuda in the Sargasso Sea and off North Australia in the Arafura and Coral Seas) and of culture isolates from two regions (Sargasso Sea and Indian Ocean) was investigated. Three independent techniques were used, including a DNA fingerprinting method based on a highly iterated palindrome (HIP1), denaturing gradient gel electrophoresis of a hetR fragment, and sequencing of the internal transcribed spacer (ITS) of the 16S-23S rDNA region. Low genetic diversity was observed in natural populations of Trichodesmium spp. from the two hemispheres. Culture isolates of Trichodesmium thiebautii, Trichodesmium hildebrandtii, Trichodesmium tenue, and Katagnymene spiralis displayed remarkable similarity when these techniques were used, suggesting that K. spiralis is very closely related to the genus TRICHODESMIUM: The largest genetic variation was found between Trichodesmium erythraeum and all other species of Trichodesmium, including a species of KATAGNYMENE: Our data obtained with all three techniques suggest that there are two major clades of Trichodesmium spp. The HIP1 fingerprinting and ITS sequence analyses allowed the closely related species to be distinguished. This is the first report of the presence of HIP1 in marine cyanobacteria.

Bacterial Proteins↗

PubMed2001

Segregation of nitrogen fixation and oxygenic photosynthesis in the marine cyanobacterium Trichodesmium.

In the modern ocean, a significant amount of nitrogen fixation is attributed to filamentous, nonheterocystous cyanobacteria of the genus Trichodesmium. In these organisms, nitrogen fixation is confined to the photoperiod and occurs simultaneously with oxygenic photosynthesis. Nitrogenase, the enzyme responsible for biological N2 fixation, is irreversibly inhibited by oxygen in vitro. How nitrogenase is protected from damage by photosynthetically produced O2 was once an enigma. Using fast repetition rate fluorometry and fluorescence kinetic microscopy, we show that there is both temporal and spatial segregation of N2 fixation and photosynthesis within the photoperiod. Linear photosynthetic electron transport protects nitrogenase by reducing photosynthetically evolved O2 in photosystem I (PSI). We postulate that in the early evolutionary phase of oxygenic photosynthesis, nitrogenase served as an electron acceptor for anaerobic heterotrophic metabolism and that PSI was favored by selection because it provided a micro-anaerobic environment for N2 fixation in cyanobacteria.

Aerobiosis↗

PubMed2001

Cloning and characterization of the human and rat islet-specific glucose-6-phosphatase catalytic subunit-related protein (IGRP) genes.

Islet-specific glucose-6-phosphatase (G6Pase) catalytic subunit-related protein (IGRP) is a homolog of the catalytic subunit of G6Pase, the enzyme that catalyzes the terminal step of the gluconeogenic pathway. Its catalytic activity, however, has not been defined. Since IGRP gene expression is restricted to islets, this suggests a possible role in the regulation of islet metabolism and, hence, insulin secretion induced by metabolites. We report here a comparative analysis of the human, mouse, and rat IGRP genes. These studies aimed to identify conserved sequences that may be critical for IGRP function and that specify its restricted tissue distribution. The single copy human IGRP gene has five exons of similar length and coding sequence to the mouse IGRP gene and is located on human chromosome 2q28-32 adjacent to the myosin heavy chain 1B gene. In contrast, the rat IGRP gene does not appear to encode a protein as a result of a series of deletions and insertions in the coding sequence. Moreover, rat IGRP mRNA, unlike mouse and human IGRP mRNA, is not expressed in islets or islet-derived cell lines, an observation that was traced by fusion gene analysis to a mutation of the TATA box motif in the mouse/human IGRP promoters to TGTA in the rat sequence. The results provide a framework for the further analysis of the molecular basis for the tissue-restricted expression of the IGRP gene and the identification of key amino acid sequences that determine its biological activity.

Amino Acid Sequence↗

PubMed2001

Vertebral osteomyelitis in Göteborg, Sweden: a retrospective study of patients during 1990-95.

Vertebral osteomyelitis (VO) is a rare condition and the diagnosis is often overlooked initially. Delay in diagnosis may result in vertebral destruction or perforation of the spinal canal. We suggest diagnostic criteria in order to simplify the diagnosis and classification of VO. Medical records of 58 patients with VO from Göteborg during the years 1990-95 were studied retrospectively. The incidence, clinical presentation, microbiology and treatment of VO were evaluated. The median age at the time of admission was 59 y (range 13-83 y) and the male:female ratio was 1.6:1. The incidence was 2.2/100,000 inhabitants/y. Sixty-four percent of the patients were natives of Sweden. The patients were classified as definite (67%), probable (26%) and possible (7%) VO. Staphylococcus aureus was the most common infective agent (34%), followed by Mycobacterium tuberculosis (27%). The most common risk factors included recent or current infections, immunosuppressive diseases and previous surgery. CRP and ESR were elevated in 82% and 88% respectively and plain X-ray changes indicating VO were found in 56% of the patients. Radiological changes were found in 34/44 (77%) computerized tomography scans and 10/13 (77%) magnetic resonance imaging examinations. The median duration of intravenous and oral antibiotic treatment were 10 and 179 d respectively. A delay of > I month from the onset of symptoms until diagnosis was found in 38% of the patients. This indicates the need for a standardized protocol for diagnosing VO. In this paper we suggest diagnostic criteria, which have not previously been available.

Adolescent↗

PubMed2001

Fewer bacterial relapses after oral treatment with norfloxacin than with ceftibuten in acute pyelonephritis initially treated with intravenous cefuroxime.

This double-blind, multicentre study was performed at nine centres on a total of 171 patients who presented with fever (> 38.5 degrees C) and signs of acute pyelonephritis. All were initially treated with intravenous cefuroxime. After 2-3 d, when the fever had subsided and urinary culture had revealed growth of Gram-negative bacteria ( > 10(7) colony-forming units per litre), treatment was changed to oral administration of ceftibuten 200 mg b.i.d. or norfloxacin 400 mg b.i.d. for 10 d. The patients were followed for signs of bacterial or clinical relapse 7-14 d after the end of treatment. The initial clinical and bacteriological cure was excellent in both groups, but there were significantly fewer bacterial relapses after oral treatment with norfloxacin than with ceftibuten in acute febrile pyelonephritis initially treated with intravenous cefuroxime. The causal strain was eradicated in 75% of patients (73% of males, 76% of females) in the ceftibuten group and in 89% of patients (94% of males, 85% of females) in the norfloxacin group. The relative frequency of eradication was 0.84 (p < 0.05; 95%, confidence interval 0.74-0.97). Adverse events were reported by 47% of the patients in the ceftibuten group and by 38% in the norfloxacin group. This difference was not significant, but diarrhoea or loose stools occurred more frequently in the ceftibuten group.

Acute Disease↗

PubMed2001

Vision and hearing in old age.

The concomitant occurrence of hearing and visual impairment was investigated as part of an epidemiological longitudinal study of elderly people. An age cohort. originally consisting of 973 elderly people, was examined with visual and hearing tests three times at ages 70, 81-82 and 88. The best-corrected visual acuity was assessed. The hearing was measured by pure-tone audiometry and whispered and spoken voice (WSV). At age 70 there was no co-existence of visual and hearing impairments, and about 70% had normal vision and hearing. At 81-82 years 3-6% (WSV and audiometry. respectively) had low vision (VA < or = 0.3) and moderate to severe hearing loss, and more than one-tenth had normal vision and hearing. At 88 years 8-13% had low vision and moderate to severe hearing loss, and none of the men and less than one-tenth of the women had normal vision and hearing. At age 88 three times as many women as men had the combination of low vision and normal hearing. Normal vision with the combination of moderate to severe hearing loss was more often found in 88-year-old men. Mild impairments of the two senses were found in 0.5% at age 70 in 22%, 11% (WSV, audiometry) at age 81-82 and in 23%, 9% at age 88 years. At age 70 there was a statistical correlation between visual acuity and hearing measured with pure-tone audiometry in the male group. Those men with better hearing had slightly better visual capacity than those with hearing loss. No correlations were found for women at age 70 nor for women and men at ages 81-82 and 88. Ophthalmologists and audiology physicians should cooperate closely in the rehabilitation process to reduce disability and improve function and wellbeing among the oldest old.

Aged↗

PubMed2001

Health-related quality of life in patients with laryngeal cancer: a post-treatment comparison of different modes of communication.

INTRODUCTION: The effects of different treatment modalities and voice and speech rehabilitation methods on the quality of life in patients with laryngeal cancer are not fully understood. MATERIALS AND METHODS: A cross-sectional post-treatment questionnaire survey of 125 patients with laryngeal cancer was performed. The response rate was 74%. Three patient groups were identified: patients treated with radiotherapy and communicating with preserved larynx (n = 70), laryngectomized patients using a tracheoesophageal prosthesis (TEP) for speech (n = 14), and laryngectomized patients communicating with an electrolarynx (n = 5). Two established generic questionnaires, the Sickness Impact Profile (SIP) and the Hospital Anxiety and Depression (HAD) scale, were used. RESULTS: The radiotherapy and the TEP groups displayed similar SIP and HAD profiles. No significant differences were seen in favor of the radiotherapy group, whereas the TEP group reported fewer problems in the SIP sleep/rest subscale. In 10 of 12 SIP categories, the numerically highest proportion of patients with clinically important dysfunction (SIP scores >10) was found in the small electrolarynx group. CONCLUSION: Successful speech rehabilitation with a TEP after laryngectomy may be as effective as conservative treatment with radiotherapy for laryngeal cancer with regard to psychosocial adjustment and functional ability, as measured with generic quality of life instruments.

Aged↗

PubMed2001

EAU guidelines for the management of urinary and male genital tract infections. Urinary Tract Infection (UTI) Working Group of the Health Care Office (HCO) of the European Association of Urology (EAU).

A short version of the UTI Guidelines elaborated by the Urinary Tract Infection Working Group of the Health Care Office of the European Association of Urology is presented. The topics include classification, diagnosis, treatment and follow-up of uncomplicated UTI, UTI in children, UTI in diabetes mellitus, renal insufficiency, renal transplant recipients and immunosuppression, complicated UTI due to urological disorders, sepsis syndrome, urosepsis, urethritis, prostatitis, epididymitis, orchitis and principles of perioperative prophylaxis in urology.

Anti-Infective Agents, Urinary↗

PubMed2000

Examination of the transcription factor NtcA-binding motif by in vitro selection of DNA sequences from a random library.

A recursive in vitro selection among random DNA sequences was used for analysis of the cyanobacterial transcription factor NtcA-binding motifs. An eight-base palindromic sequence, TGTA-(N(8))-TACA, was found to be the optimal NtcA-binding sequence. The more divergent the binding sequences, compared to this consensus sequence, the lower the NtcA affinity. The second and third bases in each four-nucleotide half of the consensus sequence were crucial for NtcA binding, and they were in general highly conserved. The most frequently occurring sequence in the middle weakly conserved region was similar to that of the NtcA-binding motif of the Anabaena sp. strain PCC 7120 glnA gene, previously known to have high affinity for NtcA. This indicates that the middle sequences were selected for high NtcA affinity. Analysis of natural NtcA-binding motifs showed that these could be classified into two groups based on differences in recognition consensus sequences. It is suggested that NtcA naturally recognizes different DNA-binding motifs, or has differential affinities to these sequences under different physiological conditions.

Bacterial Proteins↗

PubMed2000

Biochemical characterization of a beta cell membrane fraction antigenic for autoreactive T cell clones.

The two NOD-derived T cell clones, BDC-2.5 and BDC-6.9, are CD4+, Vbeta4+, islet-specific, and diabetogenic. These two T cell clones show different response patterns to whole islet cell antigen, but were found to respond to the same fraction isolated from beta granule membranes. The clones were used to follow the antigenic activity in the biochemical purification of a beta cell membrane detergent lysate subjected to HPLC anion exchange (IEX) and size exclusion chromatography (SEC). Antigenic activity could be retained after lysis in only one detergent (octyl-beta-glucoside) among several tested. In order to detect solubilized antigen, beta membrane proteins were covalently linked to microlatex beads prior to being added to T cell proliferation assays, a technique that eliminated detergent toxicity and resulted in increased assay sensitivity. To purify the antigen, membrane proteins were absorbed onto an anion exchange column and after elution using a salt gradient, activity for the clones was found in a fraction containing 0.15-0.2 M NaCl. Subsequent analysis of this material by size exclusion chromatography provided an apparent molecular weight of the antigen to be between 50 and 80 kDa. Further attempts to purify the protein by SDS-PAGE resulted in loss of antigenic activity. It is possible that the elusive nature of this protein is a clue to its importance as an autoantigen.

Animals↗

PubMed2000

Cyanobacterial diversity in geographically related and distant host plants of the genus Gunnera.

The diversity among 45 cyanobacterial isolates from 11 different Gunnera species originating from different geographical areas was examined. By means of polymerase chain reaction (PCR) fingerprinting with short tandemly repeated repetitive (STRR) sequences as primers, ten groups of symbiotic cyanobacteria and five unique isolates not belonging to a particular group were identified. Most groups were restricted to one geographical area, indicating a limited distribution of related cyanobacterial strains. An extensive cyanobacterial diversity was found both within and between the 11 different Gunnera species. Within a particular plant and even within the same stem gland, more than one cyanobacterial strain at a time could be present. These results indicate a low specificity in Gunnera-Nostoc symbiosis.

Cyanobacteria↗

PubMed2000

Functional assessment in vitro of human-complement-dependent antibody-induced cytotoxicity of neoplastic cells.

The complement system is one potential cytotoxic effector mechanism that might be effective in immunotherapy of cancer using monoclonal antibodies (mAb) directed against tumor antigens. In order to evaluate the treatment outcome from trials using mAb in cancer patients, assessment of complement-dependent cytotoxicity (CDC) may therefore be of interest. Here we describe the elaboration of a CDC assay in vitro using a rat hepatoma cell line, H4-II-E, as target cells sensitised with mAb F12, directed against the tumor-associated ganglioside antigen fucosyl-GMI. Sensitised cells were incubated with various concentrations of fresh serum as complement source for 48 h and cytotoxicity was then assessed by the tetrazolium bromide (MTT) test. A large variation in CDC efficacy was observed between individual serum donors. No differences in CDC could be seen between healthy donors and cancer patients. The CDC showed a strong correlation to the serum concentrations of complement factor C4, supporting the validity of the assay. Our results suggest that there may be significant variations in complement function within and between individuals that might influence the outcome of clinical mAb therapy. The H4/F12 CDC assay described here, together with measurement of individual complement factors. such as C4, should be further validated in cancer patients at various disease stages and phases of treatment.

Animals↗

PubMed2000

Reactivity of monoclonal antibodies with ganglioside antigens in human small cell lung cancer tissues.

Gangliosides on tumor cells have been suggested as potential target antigens for specific immunotherapy in various types of cancer including small cell lung cancer (SCLC). In this study we have compared the expression of three gangliosides that have been described as tumor-associated antigens, FucGM1, GM2 and GD3 in SCLC tissue specimens collected at autopsy, using a double-layer immunofluorescence staining method and specific monoclonal antibodies (Mabs) directed against these ganliosides. We found expression of FucGM1, GD3 and GM2 in (70% (n=20), 60% (n=15) and 40% (n75% of the tumor cells in all lesions from the same patient (five of eight cases). Our results indicate that FucGM1 is a relevant ganglioside antigen in SCLC, and suggest that specific immunotherapy involving more than one ganglioside antigen in SCLC should at least include FucGM1 and GD3.

Antibodies, Monoclonal↗

PubMed2000

Women physicians and stress.

Most women physicians enjoy better than average physical health and lead satisfying and productive lives. However, higher than average rates of depression, anxiety, marital problems, and substance abuse have been reported by some, but not all, authors. This quantitative survey of 196 women physicians and qualitative focus groups with 48 other women physicians was conducted to determine perceptions of their health, stress, satisfaction, knowledge, and abuse rates in medical practice. Eight specialties plus family practice physicians participated. The average age was 44.1 years (SD 8.8, range 23-77). Seventy-four percent of women physicians were married, with children. Specialists and family physicians were similar in all demographic characteristics except that family physicians were more significantly likely to be divorced, separated, or widowed (p < or = 0.01). Specialists perceived their personal physical health to be better than that of family doctors (p < or = 0.05), and family physicians rated their medical knowledge better than that of specialists (p < or = 0.0001). Women physicians over age 50 or with children over age 19 reported the best mental health (p < or = 0.0001 and 0.003, respectively). Overall, 49% of women physicians reported usually having high levels of stress, 44% felt mentally tired, and 17% took antidepressant drugs. Seventy-three percent reported verbal abuse at work (71% in the last year), and 33% reported physical assault at work (11% in the last year). Focus groups identified three major sources of stress: high expectations, multiple roles, and work environment. These results are discussed and compared with the literature. Both personal and systemic strategies are required to solve the problems identified. Women physicians can facilitate the adoption of some of these strategies by sharing information about successes, challenges, and solutions.

Adult↗

PubMed2000

Psychosocial support in rehabilitation after orthopedic injuries.

OBJECTIVE: Several studies have shown that psychosocial factors play a significant role in the recovery process after injuries. The aim of this study was to investigate whether psychosocial support would have a beneficial effect on outcome. METHODS: A total of 151 patients with orthopedic injuries were randomized into an intervention group and a control group. The intervention group was offered a psychosocial support program during the early phase of rehabilitation. RESULTS: One year after the injury, patients in the control group had an excess risk of having psychiatric complaints compared with patients in the intervention group (odds ratio = 2.74). They also reported a poorer quality of life according to Short Formula 36 Health Survey subscores for General Health (odds ratio = 2.3) and Vitality (odds ratio = 2.45). The length of the sick leave period did not differ between the groups. CONCLUSION: Psychosocial support during the early phase of rehabilitation after orthopedic injuries may have a beneficial effect on outcome when measured as quality of life.

Adolescent↗

PubMed2000

Self-reported health in relation to medical health and gender-specific problems in women.

Self-reported health was studied in relation to physiological measures, gender-specific problems, and clinical evaluation in 61 middle-aged women employed in a male-dominated industry. Using self-reported somatic health as the dependent variable, 50% of the variability was explained by the dimension workplace culture and the ratio low-density lipoprotein/high-density lipoprotein. Some women who reported good health were diagnosed with distress but showed no ill-health factors. However, they reported experiences of gender-specific problems more often than the women who were diagnosed as being healthy. We concluded that self-report scales seem not to be enough to identify people who look healthy on standard health scales but who use psychological defenses. Differentiating methods such as gender-specific questions, physiological ratio-measures, and clinical judgment seem to be important for distinguishing genuine from illusory mental or physical health.

Adult↗

PubMed2000

Tirapazamine plus cisplatin versus cisplatin in advanced non-small-cell lung cancer: A report of the international CATAPULT I study group. Cisplatin and Tirapazamine in Subjects with Advanced Previously Untreated Non-Small-Cell Lung Tumors.

PURPOSE: A phase III trial, Cisplatin and Tirapazamine in Subjects with Advanced Previously Untreated Non-Small-Cell Lung Tumors (CATAPULT I), was designed to determine the efficacy and safety of tirapazamine plus cisplatin for the treatment of non-small-cell lung cancer (NSCLC). PATIENTS AND METHODS: Patients with previously untreated NSCLC were randomized to receive either tirapazamine (390 mg/m(2) infused over 2 hours) followed 1 hour later by cisplatin (75 mg/m(2) over 1 hour) or 75 mg/m(2) of cisplatin alone, every 3 weeks for a maximum of eight cycles. RESULTS: A total of 446 patients with NSCLC (17% with stage IIIB disease and pleural effusions; 83% with stage IV disease) were entered onto the study. Karnofsky performance status (KPS) was >/= 60 for all patients (for 10%, KPS = 60; for 90%, KPS = 70 to 100). Sixty patients (14%) had clinically stable brain metastases. The median survival was significantly longer (34.6 v 27. 7 weeks; P =.0078) and the response rate was significantly greater (27.5% v 13.7%; P <.001) for patients who received tirapazamine plus cisplatin (n = 218) than for those who received cisplatin alone (n = 219). The tirapazamine-plus-cisplatin regimen was associated with mild to moderate adverse events, including acute, reversible hearing loss, reversible, intermittent muscle cramping, diarrhea, skin rash, nausea, and vomiting. There were no incremental increases in myelosuppression, peripheral neuropathy, or renal, hepatic, or cardiac toxicity and no deaths related to tirapazamine. CONCLUSION: The CATAPULT I study shows that tirapazamine enhances the activity of cisplatin in patients with advanced NSCLC and confirms that hypoxia is an exploitable therapeutic target in human malignancies.

Adult↗