Search PubMed⌕ Search

Biomedical subjects

B Johansson

Publications and source records attributed to B Johansson.

At least 343 records · Page 19Linked to original sources
PubMed1995

CMV PCR monitoring in leucocytes of transplant patients.

BACKGROUND: The presumed latency of cytomegalovirus (CMV) in leucocytes and the sensitivity of the polymerase chain reaction (PCR) raise a question of its clinical value. OBJECTIVES: To develop and standardize a CMV PCR as a diagnostic tool for CMV infection in solid organ and bone marrow transplant patients by comparing it to a likewise standardized isolation, rapid isolation and to clinical symptoms. STUDY DESIGN: The material comprised 822 EDTA peripheral blood samples from 96 solid organ and 119 bone marrow transplant patients. One sample from each of 21 healthy bone marrow donors and 25 blood donors were used as controls. Two million leucocytes were lysed and one-tenth of a volume was used in a nested PCR employing immediate early gene primers. RESULTS: The limit of detection was approximately 10 gene copies of a CMV DNA clone and 1 TCID(50) of extracted DNA from a cell suspension. The specificity was >/=0.99 when tested in CMV seronegative individuals. The positive and negative predictive values were 0.62 and 1.00, respectively. When PCR was compared to virus isolation/rapid culture in individual patients, PCR was positive more frequently in solid organ transplant patients than was CMV isolation/rapid culture, but the difference was not significant in bone marrow transplant patients. In isolation-positive patients, PCR became positive in samples taken 1-2 weeks earlier. In 54 solid organ transplant patients with PCR-positive samples, CMV-associated symptoms were present in 29/31 patients with CMV isolated from blood but in only 5/23 patients without viraemia. In 17 bone marrow transplant patients treated with ganciclovir, PCR became negative during or immediately after treatment in 14/20 (70%) episodes. This was true of 5/12 (42%) solid organ transplant patients. CONCLUSION: Screening of transplant patients with CMV PCR can be standardized at a clinically relevant level so that antiviral therapy can be instituted early.

Journal Article↗
PubMed1995

Polymerase chain reaction for the early diagnosis of cytomegalovirus hepatitis in liver transplant patients.

BACKGROUND: In liver transplant (LTX) patients, cytomegalovirus (CMV) hepatitis as a cause of graft dysfunction occurs in 15-25% of the patients. Polymerase chain reaction (PCR), applied to liver biopsy specimens, may increase the ability to detect CMV DNA at a local site. In this study, PCR was used to compare its relation to the development of clinical CMV hepatitis. STUDY DESIGN: Nested polymerase chain reaction (nPCR), derived from a conserved region of the CMV major immediate-early gene, was used to examine 141 frozen liver biopsies from 61 LTX patients for the presence of CMV DNA. 134 biopsies were obtained from 54 patients with pathological liver function tests within four months after transplantation. The remaining seven patient biopsies were derived from the one-year investigation after LTX and served as controls. The results were compared to virus isolation, antigen detection by immunohistology and in situ hybridization for CMV DNA of the biopsy specimens. Histological examination was performed to verify a diagnosis of viral hepatitis. RESULTS: CMV DNA was amplified in 11% (15/134) of the biopsies, corresponding to 20% (11/54) of the patients. Virus isolation revealed CMV in 5% (7/134) of the samples. None of the nPCR-negative biopsies was virus culture positive. CMV genomes were detected by nPCR more frequently than CMV hepatitis was diagnosed by using the combination of CMV-specific histopathology and/or immunohistology and/or CMV-positive virus isolation (p < 0.01). However, when this comparison was performed within individual patients, the difference was not significant (p > 0.05). If the results of in situ hybridization were included in the diagnostic criteria of CMV hepatitis, the nPCR was comparable to these, both at the biopsy and the patient levels (p > 0.1 and p > 0.05, respectively). For the diagnosis of CMV hepatitis the negative predictive value of CMV-nPCR was 1.0. The positive predictive value ranged from 0.55 to 0.82 depending on the criteria of CMV hepatitis. The nPCR also detected signs of CMV infection in the liver graft earlier than virus isolation, 11 versus 21 days, respectively, after transplantation. CONCLUSION: The frequency of CMV DNA positivity, measured by nPCR, was similar to that revealed by other combined methods. We suggest that the combined findings of histological cholangitis and/or lobulitis together with nPCR for CMV DNA can be used as a diagnostic criterion for initiation of antiviral treatment against CMV hepatitis.

Journal Article↗
PubMed1995

Properties of liquid ionization chambers at LDR brachytherapy dose rates.

Properties such as sensitivity, general recombination and reproducibility of liquid-filled parallel-plate ionization chambers for dosimetry in low-dose-rate brachytherapy radiation fields have been evaluated. Two different dielectric liquids, isooctane (C8H(1)8) and tetramethylsilane (Si(CH3)4), have been used as sensitive media in chambers having a coin-shaped sensitive volume of 3 mm in diameter and 1 mm thickness. An electric field strength of 300 kV m-1 was found to be optimal with respect to sensitivity, leakage current and general recombination. At absorbed dose rates from 0.1-100 mGy min-1 the ionization charge measurements at an irradiation time of 1 min showed a reproducibility better than 1%, and a general recombination not exceeding 0.5%. The calibration--absorbed dose to water against ionization charge at a 60Co reference source--did not show any significant change over an observation time of one year for any of the chambers.

Brachytherapy↗
PubMed1995

Immune parameters in a longitudinal study of a very old population of Swedish people: a comparison between survivors and nonsurvivors.

As a part of an ongoing longitudinal investigation, this study examined relationships between survival and selected immune system parameters in a sample (n = 102) of very old individuals (86-92 years at the time of initial immune system data collection). Analyses were performed comparing initial time-point measurements from those individuals who were alive (n = 75) and those who were deceased (n = 27) two years after initial data collection. Immune system measurements consisted of determination of peripheral blood lymphocytes and lymphocyte subsets, as well as T-cell responses to activation by Concanavalin A. Cluster analysis identified a subgroup associated with nonsurvival which indicated characteristics that included: poor T-cell proliferative responses, high CD8 percentages, and low CD4 and CD19 percentages. This multivariate analysis suggested that combinations of immune system parameters predict two-year survival otherwise not apparent when single immune system parameters were evaluated in the elderly.

Aged↗
PubMed1995

Continuity and discontinuity in the anti-V3 IgG response of human immunodeficiency virus type 1-infected persons in a cross-sectional and longitudinal study using synthetic peptides.

The principal neutralization domain (PND) of the V3 region of human immunodeficiency virus type 1 (HIV-1) gp120 is central to HIV pathogenesis. The IgG antibody response to PND was followed in 15 HIV-1-infected persons from southern Sweden over 2-5 years using 32 synthetic V3 peptides. Five peptides had amino acid sequences derived from isolates from each of 5 patients. Sera obtained simultaneously with isolate almost always reacted strongly with these cognate peptides; however, reactivity was undetectable in 1 patient's serum and short lived in the sera of another, indicating inducible holes in the antibody repertoire, which would facilitate dissemination of the corresponding virus strains. Reactivity to other V3 peptides correlated with sequence similarity to the cognate peptide. Strong, stable reactivity to peptides with sequences similar to a south Swedish V3-consensus was accompanied by transient activity to less similar ones. The latter may reflect viral variation, B lymphocyte clonal depletion, or both. Certain IgG responses appeared to preclude others, suggesting clonal dominance.

Acquired Immunodeficiency Syndrome↗
PubMed1995

Fixed versus response-adapted MOPP/ABVD chemotherapy in Hodgkin's disease. A prospective randomized trial.

BACKGROUND: The optimal number of chemotherapy courses in responding patients with advanced-stage Hodgkin's disease (HD) is unknown. PATIENTS AND METHODS: With minimizing chemotherapy and thereby reducing late complications as the objective, patients with advanced HD were randomized to receive either 4 full MOPP/ABVD courses or treatment up to complete remission (CR). Forty-seven patients were given the fixed (FT) and 41 patients the individual treatment (IT). The two groups were balanced according to age, histopathology and sex, although stage IVB dominated in the IT group (20 vs. 8). RESULTS: Sixty-six of 88 patients (75%) achieved CR. No difference between the two treatment groups in the proportion of stage IVB patients was seen when those achieving CR, i.e., the efficacy population were compared. The mean number of single chemotherapy courses given was 3.7 of MOPP and 3.5 of ABVD in the FT group, compared to 2.6 of MOPP and 2.5 of ABVD in the IT group (p < 0.001). The predicted progression-free survival at 10 years was 81% in the FT and 68% on the IT arm, respectively (p < 0.05). No statistically significant difference in cause-specific 10 year survival was observed (82% and 83%, respectively; p = 0.18). Long-standing CRs were achieved following minimal chemotherapy. CONCLUSIONS: Since there are no available methods to identify long-term disease-free survivors among CR patients following a limited induction treatment, we suggest that the policy of giving 3-4 full MOPP/ABVD courses should continue. The price for such an approach is the overtreatment of a subset of already cured patients.

Adolescent↗
PubMed1995

Immune-mediated complications in patients with myelodysplastic syndromes--clinical and cytogenetic features.

It has been recognized in recent years that some patients with myelodysplastic syndromes (MDS) develop immune-mediated complications (IMC), but little is known about the correlations to MDS-specific disease features. In a retrospective study of 82 MDS patients, we identified 10 (12%) with IMC (group A) and compared them to the remaining 72 cases (group B). Group A consisted of 5 patients with biopsy-verified skin vasculitis and 1 case each with temporal arteritis/polymyalgia rheumatica, necrotising panniculitis, Hashimoto's thyroiditis, autoimmune thrombocytopenia, and Sweet's syndrome. Survival times, sex ratio and distribution of MDS subtypes were similar in the two groups. The patients in group A were younger than those in group B (median 66 vs. 76 years, p < 0.01). Four patients (40%) in group A had a history of previous genotoxic therapy for malignant disorders. The bone marrow karyotype was evaluated in 62 patients. Clonal chromosomal abnormalities were found more frequently in Group A than in group B (8/9 vs. 26/53, p = 0.03), and complex karyotypes, i.e., three or more aberrations, were also observed to be more common in group A (3/9 vs. 8/53). The results indicate that IMC preferentially develop in patients with secondary MDS, in younger MDS cases, and in patients with cytogenetic abnormalities.

Adolescent↗
PubMed1995

Effect of different xanthines and phosphodiesterase inhibitors on c-fos expression in rat striatum.

It has previously been shown that caffeine, in a dose-dependent manner, increases the expression of the protooncogene c-fos in the rat brain, predominantly in the caudate-putamen and tuberculum olfactorium. In this study we examined the effect of related xanthines and of selective phosphodiesterase inhibitors on c-fos expression. The effect of caffeine (75 mg kg-1) was mimicked by 3-isobutyl-1-methyl xanthine (IBMX) (25 mg kg-1) and theophylline (100 mg kg-1) but not by 8-p-sulfophenyltheophylline (10 mg kg-1), enprofylline, theobromine or paraxanthine (each at 100 mg kg-1). Moreover, the cyclic AMP-selective phosphodiesterase inhibitors rolipram (10 or 20 mg kg-1) and SQ 20,006 (25 mg kg-1) and the cyclic GMP-selective phosphodiesterase inhibitor zaprinast (10 mg kg-1) failed to induce c-fos in striatum, but caused a clear-cut induction in the overlying cerebral cortex. Thus, c-fos is induced in rat striatum following administration of caffeine and other xanthines that (provided they enter the brain) block adenosine receptors, suggesting an involvement of central adenosine receptors. Inhibition of cyclic nucleotide phosphodiesterase does not appear to play any important role in c-fos induction by the xanthines.

1-Methyl-3-isobutylxanthine↗
PubMed1995

Changes in functional competency in the oldest old. A longitudinal study.

Changes in everyday functioning and cognitive abilities are studied longitudinally in a representative sample of the oldest old. Respondents were selected by using census records from all people aged 84, 86, 88, and 90 years old living in an area of South Central Sweden, and then were assessed at 2-year intervals. The findings show high base rates for disabilities and high incidence of cognitive and functional deficits among survivors. Mortality is associated with higher rates of disability at the previous time of assessment. Because of this increased mortality rate among disabled individuals, prevalence does not rise as much as would be expected from the high incidence. Instead, new cases of disabled are partly replacing disabled individuals who died since the previous evaluation.

Activities of Daily Living↗
PubMed1995

Laparoscopic Rosetti fundoplication.

BACKGROUND: Early experiences with laparoscopic fundoplication using the Rosetti technique are presented and compared with retrospective results from conventional fundoplication procedures. METHODS AND RESULTS: We have performed 70 consecutive laparoscopic procedures. Conversion to open surgery was done in seven cases because of anatomical reasons and in two because of peroperative progressive subcutaneous emphysema and CO2-retention. The complication rate was low. The range of postoperative hospital stay is 1-4 days for non-converted patients. Symptomatic follow-up has hitherto been performed in 41 patients with a follow-up time of 3-9 months. The follow-up results do not differ from those achieved in patients operated upon with the conventional open Nissen (n = 41) and Rosetti (n = 36) techniques. Pre- and postoperative control of 24 h pH and lower esophageal sphincter pressure (LESP) in 19 laparoscopically treated patients showed normalization of LESP in all cases and postoperative 24 h pH < 4 ranging between 0 and 3%. CONCLUSIONS: Laparoscopic and reflux surgery is effective for the treatment of reflux esophagitis. Follow-up results compare well with open surgery.

Adolescent↗
PubMed1995

Quality of Life assessments in the evaluation of gastroesophageal reflux and peptic ulcer disease before, during and after treatment.

BACKGROUND: It has recently been suggested that Quality of Life (QOL) be used in the evaluation of new medical treatment regimens together with cost-benefit, efficacy and safety. In this overview we point out some aspects of use of the Psychological General Well-Being Index (PGWB) in patients with peptic ulcer and reflux disease gained from our own investigations in later years. METHODS: QOL was assessed using questionnaires before diagnosis, during medical healing treatment and at a 1-year follow-up in peptic ulcer disease or before and after surgery in reflux disease. RESULTS: Untreated patients with unknown diagnosis had low QOL scores. With treatment, scores increased rapidly to supernormal values and fell off to normal values during the follow-up year. CONCLUSION: QOL evaluations seem sensitive and reflect the patient's subjective feeling of disease. They add another new aspect of treatment effect not earlier included in treatment evaluations.

Female↗
PubMed1995

Waldenström's macroglobulinemia with the AML/MDS-associated t(1;3)(p36;q21).

Two unusual, and perhaps causally related, clinical and cytogenetic features in a patient with Waldenström's macroglobulinemia are presented. Firstly, during the progression of the primary macroglobulinemia bone destruction and hypercalcemia occurred. Secondly, a t(1;3)(p36;q21) was found as the sole clonal chromosomal abnormality. This translocation is characteristic of acute myeloid leukemia (AML) and myelodysplastic syndromes with a high propensity for progressing to AML. The t(1;3) has previously never been reported in a lymphoproliferative disorder. Since the abnormality is associated with acute transformation of cells of the myelopoietic lineages, it is possible that the t(1;3), found in cells of lymphoid origin in the present case, not only induced the neoplastic process as such but also brought about the unusually malignant tumor progression.

Chromosomes, Human, Pair 1↗
PubMed1995

Increased expression of c-jun, junB, AP-1, and preproenkephalin mRNA in rat striatum following a single injection of caffeine.

The effect of a single injection of caffeine on the expression of c-fos, c-jun, junB, and junD, on activator protein 1 (AP-1) and on the levels of preproenkephalin mRNA in rat striatum was studied. Male rats were given caffeine (25 mg/kg, 50 mg/kg, or 100 mg/kg, i.p.) and sacrificed at different times (0.5, 1, 2, 4, or 8 hr) after administration. By using in situ hybridization of adjacent sections we found a rapid, transient, and dose-dependent increase of c-fos, c-jun, and junB by caffeine in striatum, especially in the lateral part. The induction peaked after 1 hr, but persisted for 2 hr, and in the case of junB for 4 hr. No induction of junD was found. A strong induction of junB, a weak induction of c-fos and c-jun, but not of junD, was seen in nucleus accumbens. Furthermore, by using gel shift assay we found an induction of AP-1 by caffeine (100 mg/kg) in striatum, which peaked 2 hr after administration and was clearly increased after 4 hr. c-Fos, c-Jun, and JunB proteins were components of the AP-1. There was also a dose-dependent induction of preproenkephalin mRNA, which was most pronounced in the lateral and caudal part of striatum; the level peaked 4 hr after injection and was still significantly increased after 8 hr. In a complementary study we could not find increased binding to the AP-1-like site in the 5'-flanking sequence of proenkephalin following caffeine treatment. The data show that a single dose of caffeine induces a temporally and spatially characteristic pattern of c-fos, c-jun, and junB induction, followed by changes in AP-1 and preproenkephalin mRNA. Thus, a single dose of caffeine causes changes in gene transcription in the brain that may be related to the adaptive changes that occur after caffeine administration. However, a direct causal link between the immediate early genes and enkephalin could not be proven.

Analysis of Variance↗