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Biomedical subjects

B Johansson

Publications and source records attributed to B Johansson.

At least 685 records · Page 38Linked to original sources
PubMed1983

[Indications for the surgical correction of patients with transposition of the great arteries associated with an interventricular defect. Analysis of 98 cases operated on using the Mustard technic].

At the Hospital for Sick Children, London, between Jan. 1965 and Jan. 1980, 98 patients, ranging in age from 22 days to 20.8 years (mean = 29.6 months), with a clinical diagnosis of transposition of the great arteries (TGA) associated with a ventricular septal defect (VSD) found at cardiac catheterization, underwent Mustard procedure at the atrial level, whether or not associated with the VSD closure. Twenty-nine other patients, with irreversible obstructive pulmonary vascular disease in whom a "palliative" Mustard was performed, have been excluded from this report. At operation, in 8 cases, the VSD was found to have closed spontaneously during the interval between the cardiac catheterization and the surgical repair, while, in 13 patients, the VSD was judged to be too small to influence the hemodynamic results and, accordingly, was left open. In 35 cases the VSD was closed with mattress stitches buttressed with dacron pledgets and in 42 patients a dacron patch was used. The defects were accessible through the tricuspid valve in all but 10 cases. There were 24 early deaths (24%) and these did not correlate either with the year of operation or with the age at the time of operation. The mortality rate was higher in the cases who had required previous pulmonary artery banding (37%), than in those who had not (21.5%), but this difference was not statistically significant. The early results were related to the size of the VSD. In the 21 patients in whom the VSD was partially or completely closed, the early mortality was 9.5%.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1983

Liver and skeletal muscle metabolism, extracellular K+ concentrations, and survival in spontaneously hypertensive rats following acute blood loss.

The metabolic responses of spontaneously hypertensive rats (SHR) and normotensive Wistar-Kyoto rats (WKY) to acute blood loss (30% of the calculated blood volume) have been studied. The initial mean arterial pressure (MAP) was 179 mmHg in SHR and 105 mmHg in WKY. After bleeding, MAP decreased to about 50 mmHg in both groups. SHR failed to increase MAP in the posthemorrhagic period, while in WKY a level of 65-70 mmHg was reached. Metabolic changes in liver and skeletal muscle, indicative of tissue hypoxia, occurred earlier and were more pronounced in SHR than in WKY. In SHR, the ATP content of the liver was almost depleted within 1 h, while during the same time period only a moderate reduction was seen in WKY. Extracellular K+ concentration in sketetal muscle increased more rapidly in SHR than in WKY, but a similar relationship between lactate content and extracellular K+ concentration was found in both groups. The mean posthemorrhagic survival time was only 47 min for SHR, as compared to 193 min for WKY. The present results indicate that a blood loss is more detrimental for hypertensive than normotensive rats.

Acute Disease↗
PubMed1983

CCNU toxicity after an overdose in a patient with Hodgkin's disease. Effects on colony-forming cells (CFU-C) and colony-stimulating activity (CSA).

An overdose of CCNU (600 mg over a 15-d period) was unintentionally ingested by a patient with advanced Hodgkin's disease subjected to combination chemotherapy. A severe bone marrow depression occurred 3 weeks after the start of the CCNU treatment. The nadir of the platelet count was reached after 4 weeks and that of the granulocyte count after 5 weeks. At the nadir of the white blood cell count, colony-forming cells (CFU-C) were found in significantly reduced numbers in the bone marrow, and were not found at all in the peripheral blood; the amount of colony-stimulating activity (CSA) produced by peripheral blood cells was reduced. However, the cells producing CSA recovered earlier than the CFU-C, and the CSA peak value was reached about 1 week before the peak value for CFU-C in the bone marrow. Thus, in vivo CSA-producing cells appeared to be more resistant to CCNU than were CFU-C, and their recovery appeared to be a prerequisite for the recovery of CFU-C and myelopoietic cells.

Animals↗
PubMed1982

Interferon and natural killer activity in multiple myeloma. Lack of correlation between interferon-induced enhancement of natural killer activity and clinical response to human interferon-alpha.

Natural killer (NK) activity of peripheral lymphocytes was measured in 39 patients with multiple myeloma prior to and during interferon (IFN) therapy. NK activity increased in a majority of patients following the first injection of IFN and remained at an increased level during 1 year of therapy. Lower doses of IFN seemed to induce a greater increase in NK activity than higher doses. No correlations could be observed between the response of the tumors to IFN therapy and pretreatment levels of NK activity, IFN-induced enhancement of NK activity in vitro or IFN-induced enhancement of NK activity in vivo.

Adult↗
PubMed1982

Epidemiological study of nasal and nasopharyngeal cancer and their relation to phenoxy acid or chlorophenol exposure.

Soft tissue sarcoma and malignant lymphoma have been related to exposure to chlorinated phenoxy acids or chlorophenols as well as exposure to organic solvents and malignant lymphoma. However, colon cancer studied by the same case-referent design did not show any such associations, which helps to rule out alleged systematical bias of the study approach. Further considerations about exposure routes for phenoxy acids and chlorophenols suggested that nasal and nasopharyngeal cancers should be studied. Forty-four cases with nasal cancer and 27 cases with nasopharyngeal cancer were eligible for study during 1970-1979 together with 541 referents, as utilized also in the aforementioned studies. Exposure to phenoxy acids gave formally a doubled but insignificant risk for the studied cancer types. Exposure to chlorophenols, as present particularly in woodwork, was related to an about sevenfold and significant increase in the risk for both cancer types. In woodworkers without exposure to chlorophenols there was an approximate normal risk, but cabinet makers, even without exposure to chlorophenols, had nearly doubled (but insignificant) risk of nasal cancer.

Adenocarcinoma↗
PubMed1982

Treatment of chronic lymphocytic leukaemia and well-differentiated lymphocytic lymphoma with continuous low- or intermittent high-dose prednimustine versus chlorambucil/prednisolone.

Prednimustine, a new antitumour drug, is a chlorambucil ester of prednisolone. The present prospective randomized study compares the effect of continuous low-dose (B) and intermittent high-dose (C) prednimustine in previously untreated patients with progressive CLL and WDLL. The control group received continuous chlorambucil/prednisolone therapy (A). One hundred and eighteen patients, 88 CLL and 30 WDLL, were evaluable. Response to therapy (greater than 50% improvement) was noted in 61, 55 and 57% in groups A, B and C respectively. The difference was not statistically significant. Time to response, response duration and survival did not show any differences between the groups. Responding patients survived longer than patients with stationary and progressive disease. Median survival time was 72 months from diagnosis and 52 months from start of therapy, with no differences between the treatment groups. Toxicity of prednimustine was usually mild and similar to that of the two constituents. Treatment schedule C showed a slight advantage with regard to frequency of side effects. In conclusion, in this study the therapeutic effect of prednimustine was equal to that of its constituents administrated separately.

Adult↗
PubMed1982

Lymphocyte function in untreated Hodgkin's disease: an important predictor of prognosis.

One hundred and twenty seven consecutive and previously untreated patients with Hodgkin's disease (HD) (mean age 47 years) from the Stockholm area admitted to Radiumhemmet, Karolinska Hospital, were studied. The age-matched control group consisted of 167 healthy adults. Incorporation of [14C]-dT was measured on Day 1 in unstimulated monocyte-depleted lymphocyte cultures, and on Day 3 in cultures activated by PWM, ConA and PPD, T and B cells were enumerated by surface markers. The patients had significantly decreased relative and total T-cell counts, and the lymphocyte DNA synthesis induced by mitogens and PPD was severely impaired, whilst the spontaneous DNA synthesis was significantly greater than in controls. At follow-up (mean 4 years) 40 patients have died. Deceased patients showed greater spontaneous lymphocyte activation and less response to mitogen and antigen stimulation than the survivors. The 5-year survival of patients with severe lymphocyte impairment was 20%, compared to 80% for the remainder. The lymphocyte tests added prognostic information to that from clinical staging. Disregarding the lack of knowledge of the mechanisms underlying the lymphocyte impairment, we suggest that these relatively simple immunological tests should be included in the clinical evaluation of HD patients and would guide the choice of therapy.

Adolescent↗
PubMed1982

Experience with a cooperative bone marrow transplantation program in Stockholm.

Twenty-seven patients (age range from 1 to 55 years) were included in a cooperative bone marrow transplantation program in Stockholm. Of eight patients with severe aplastic anemia (SAA), two died following graft rejection and six (75%) are alive between 3 months and 4 1/2 years after transplantation. Two patients with end stage leukemia died of septicemia and bleeding shortly after transplantation. Thirteen of 17 patients (76%) with acute leukemia in their first or second remission are alive 1 to 16 months after transplantation. Death was caused by septicemia in two patients, interstitial Candida pneumonitis in one and gastrointestinal bleeding in association with graft-versus-host disease in one. Among the leukemic patients all deaths occurred in subjects over 17 years of age and all 10 children are alive. No relapse has yet been seen. Successful bone marrow transplantations were carried out utilizing ordinary hospital resources only. This justifies the practice of performing transplantations in subjects with SAA and acute leukemia in remission even outside specially equipped and designed bone marrow transplantation units.

Acute Disease↗
PubMed1982

The haemodynamic effects of intravenous prenalterol and ouabain in conscious dogs.

Experiments were performed on 5 resting conscious dogs supplied with an electromagnetic flow probe on the ascending aorta and a chronic aortic catheter for pressure recording. The animals were used repeatedly in four different types of experiment involving i.v. administration of 1. saline (controls), 2. prenalterol 45 nmol/kg (approximately 10 micrograms/kg) followed by an additional dose of 135 nmol/kg 20 min later, 3. ouabain 50 nmol/kg (approximately 30 micrograms/kg) and 4. a combination of protocols 2. and 3. Ouabain and the low dose of prenalterol exerted clear-cut positive inotropic effects as reflected in increased stroke volume and max dF/dt without significant changes in heart rate or arterial pressure. The PQ interval increased with ouabain but decreased with prenalterol. The higher dose of prenalterol caused a further rise in max dF/dt, a further shortening of the PQ time, increased heart rate and reduction in systemic vascular resistance. Higher doses of ouabain could not be given due to side-effects (vomiting). The combined treatment with ouabain and prenalterol showed their inotropic responses to be additive. Arrhythmias did not occur in any of the animals at the applied dose levels of the drugs. The experiments show that prenalterol through its beta 1-adrenoceptor stimulating action exerts a positive inotropic effect which surpasses that of emetic doses of ouabain. The inotropic response at moderate doses occurs without a change in heart rate. This fact and the apparent lack of influence of prenalterol on vascular alpha- and beta 2-adrenoceptors make the substance potentially useful clinically as an inotropic agent in cardiac failure, particularly in view of its relatively long duration of action.

Adrenergic beta-Agonists↗
PubMed1982

Cerebrovascular permeability and cerebral blood flow in hypertension induced by gammahydroxybutyric acid. An experimental study in the rat.

A sustained increase in blood pressure was obtained by intraperitoneal (i.p.) or intravenous (i.v.) administration of gammahydroxybutyric acid (GHBA, 1 g/kg) in rats under nitrous oxide anesthesia and in conscious rats with indwelling catheters in the aorta and a jugular vein. Evans blue-albumin and 125I-labeled serum albumin, given i.v. before GHBA, were used to study the function of the blood-barrier in rats killed 60 min after the injection of the drug. Brains from rats subjected to acute hypertension while awake showed less extravasation of albumin than did brains from anesthetized rats. Sectioning of the cervical symphatetic nerves did not increase extravasation in conscious rats. The cerebral blood flow, determined with the 14C-ethanol technique, did not significantly differ in GHBA-treated rats and controls. Because of the sustained increase in blood pressure, GHBA-induced hypertension might be a useful model for the study of long-term effects on the brain of hypertensive opening of the blood-brain barrier.

Anesthesia, General↗
PubMed1982

T cells in monoclonal gammopathies.

Subpopulations of human T lymphocytes were analysed by monoclonal antibodies (OKT3, OKT4, OKT8) in healthy controls and in patients with multiple myeloma (MM), Waldenström's macroglobulinemia (WM) and benign monoclonal gammopathy (BMG). Lymphocytes forming rosettes with SRBC correlated well with T cells staining in indirect immunofluorescence by OKT3 monoclonal antibodies. The relative and absolute numbers of OKT4+ T cells were significantly lower in patients than in controls. Though, the percentage of OKT8+ T cells was increased in patients, the total OKT8+ cell counts were normal in all patient groups. The ratio between OKT4+ and OKT8+ lymphocytes was low in the groups of treated MM and of WM patients compared to controls (P less than 0.001). Moreover, the ratio was lower than the normal range in 27% of BMG and 38% of untreated MM patients. The imbalance between OKT4+ and OKT8+ T cells in untreated MM was more pronounced in clinical stage III patients than in stage I and II patients. The most pronounced changes were noted in treated MM patients. The significance of the altered T cell subsets in monoclonal gammopathies with regard to polyclonal and tumor B cell regulation remains to be established.

Adult↗
PubMed1982

Contractile properties of two varieties of twitch muscle fibres in Xenopus laevis.

The contractile properties of twitch muscle fibres in the iliofibularis muscle of Xenopus laevis with characteristic differences in light-microscopical appearance have been studied under isometric and isotonic conditions. Type 1 fibres (large, pale) have a short contraction time (tc), a shoulder in the relaxation phase, and a high twitch-tetanus ratio. In type 2 fibres (medium-to-large with abundant mitochondria and lipid droplets) tc is longer, half-relaxation time equals tc, and the twitch-tetanus is lower. The capillary density is about 4 times higher for type 2 than for type 1. Computer-fitted hyperbolic force-velocity curves gave the following Hill constants (20 degrees C) for type 1 (2) fibres: P0*/P0 1.03 (1.15), a/P0* 0.48 (0.26), b 3.51 (1.53) 10/s; extrapolated Vmax (0-0.8P0) was 7.60 (6.27) 10/s. Lowered temperature (10 degrees C) increases the curvature of the P-V relation in type 1 fibres, little effect was seen in type 2. Increased PCO2 depressed the isometric tension in both types; in type 1 fibres the P-V relation became less curved, in type 2 fibres no change in curvature was observed. The results suggest that type 1 and type 2 fibres might contain myosin isozymes with slightly different temperature- and pH-sensitivities.

Animals↗
PubMed1982

Immune status of untreated patients with Hodgkin's disease and prognosis.

In this study of 127 previously untreated adult patients with Hodgkin's disease and 167 age- and sex-matched controls, highly purified blood lymphocytes were studied for E+ receptors; their spontaneous DNA synthesis and that induced by concanavalin A, pokeweed mitogen, or purified protein derivative of tuberculin were measured as incorporation of 14C-thymidine. T-cell counts and the response to mitogens and antigen were significantly decreased in the patients, while the spontaneous lymphocyte activity was increased. Forty-nine patients had died after a mean observation time of 6 years. In these patients, there had been an increase in spontaneous DNA synthesis and a decrease in that induced by mitogens and antigen. These differences also remained significant when patients who died were compared with surviving patients in stages I-II. The 5-year survival rate of "bad immunology" patients was 30% as compared to 80% for the remainder. We suggest that these lymphocyte tests should be considered in an "immunologic staging system," which may give guidance in the future management of patients with Hodgkin's disease.

Adolescent↗
PubMed1982

Monocyte function in Hodgkin's disease.

Monocyte functions were studied in 16 patients with Hodgkin's disease, 11 untreated and five in unmaintained complete remission. Eleven untreated patients with non-Hodgkin's lymphomas and 21 healthy persons were used as controls. Monocytes were isolated from peripheral blood and enriched to greater than 90%. Lymphoma monocytes showed normal ability to lyse human RBC coated with anti-D IgG antibodies as evaluated by a 51Cr-release assay. The ability of monocytes to augment or suppress concanavalin A stimulation of lymphocytes purified to greater than 98% was studied by incubation of a number of lymphocytes with increasing amounts of purified monocytes. The incorporation of 14C-thymidine was potentiated by a factor of 10 in the presence of equal amounts of monocytes. There was no difference between monocytes from Hodgkin, non-Hodgkin or healthy controls to augment patients' autologous or normal lymphocytes. Patient monocytes also suppressed the response at the same monocyte-lymphocyte ratio as normal monocytes. Stimulation of patient lymphocytes without the addition of monocytes was usually lower than that of normal control lymphocytes. The difference between patient and control lymphocyte stimulation was preserved in the presence of monocytes. It is concluded that monocytes from patients with active Hodgkin's disease or non-Hodgkin's lymphoma have normal helper and suppressor effects on patient or normal lymphocytes stimulated by Con A and normal antibody-dependent cytotoxicity.

Antibody-Dependent Cell Cytotoxicity↗