Biomedical subjects

B Pettersson

Publications and source records attributed to B Pettersson.

At least 109 records · Page 6Linked to original sources

PubMed1988

Classification of patients subjected to extracorporeal shock wave lithotripsy.

A simple system is described for classification of patients with urolithiasis treated with extracorporeal shock wave lithotripsy (ESWL). According to the size and number of concrements in each kidney the patients were subgrouped in six different ESWL-types (A-F). The main purpose was thereby to be able to discriminate between different stone situations regarding the need for resources and to evaluate the therapeutic results in an appropriate way. Of 709 patients treated with ESWL during the first year, 2% were of ESWL-type A, 46% of type B, 24% of type C, 16% of type D, 5% of type E, and 7% of type F. There was a good relationship between ESWL-type, number of shock waves and duration of the treatment session, number of ESWL-sessions, and duration of hospital stay. With knowledge of the ESWL-type distribution in a group of patients with urolithiasis this classification provides a basis for estimates of treatment capacity and required number of beds. With a weekly capacity of 24 treatments the required number of beds usually varied between 20 and 25. The hospital stay varied between 2 and 35 days, with the longest hospital stay recorded for patients belonging to ESWL-type E undergoing a combined procedure with percutaneous surgery, ESWL, and often irrigation with hemiacidrin. The presented system for classification might be a useful tool for planning, organization and assessment of renal stone treatment based on ESWL.

Humans↗

PubMed1988

Extracorporeal shock wave lithotripsy of proximal and distal ureteral stones.

Extracorporeal shock wave lithotripsy (ESWL) was used for treatment of 105 patients with ureteral stones. There were 77 stones in the upper part of the ureter, i.e. above the pelvic brim, and 28 in the lower part, i.e. below the sacroiliac joint. Successful fragmentation was attained in 101 (96%). In 93% of the patients with stones in the upper ureter and in 100% with stones in the lower ureter the fragments were eliminated completely. In 87% of the patients with stones in the upper ureter, a ureteral catheter was introduced under local anesthesia but without fluoroscopic control. It was thereby possible to remove 30% of the stones from the ureter to the kidney. For the remaining stones, saline was infused through the catheter during ESWL. For patients with stones in the lower part of the ureter, a ureteral catheter was passed in 79% and saline infused during treatment. Whereas some form of anesthesia was used for treatment of all upper ureteral stones, 89% of the treatments for lower ureteral stones were performed without anesthesia. Auxiliary procedures after ESWL were limited to four ureteral catheter manipulations for distal stones. Four proximal stones which remained unaffected by ESWL had to be treated by open surgery (3 stones) or percutaneous surgery (1 stone). Of 82 ureteric stones treated in situ the success fragmentation rate was 95%. The average number of ESWL sessions was 1.04 for both proximal and distal ureteral stones.

Adolescent↗

PubMed1988

Periodontal healing after treatment with either the Titan-S sonic scaler or hand instruments.

Several types of air turbine scalers have recently been introduced as an alternative to ultrasonic equipment in periodontal therapy. The aim of this investigation was to compare clinical, periodontal healing after scaling with the Titan S air turbine scaler and hand instruments. Twelve patients referred to the School of Dental Hygiene, Jönköping, Sweden, for treatment of moderately advanced periodontitis participated in the study. After examination, diagnosis, treatment planning, and information, the teeth of the left and right quadrants were randomly assigned to Titan S or hand instruments scaling ("split mouth design"). The treatment was given by 6 dental hygiene students. Final re-examination was performed 3 months after instrumentation. After treatment, a marked improvement of periodontal conditions, expressed as number of tooth surfaces with plaque, number of sites with probing pocket depth greater than or equal to 4 mm and percentage of sites showing bleeding on probing to the bottom of the pocket, was obtained. No difference in results was observed when comparing Titan S and hand instrumentation. The time required for instrumentation was, however, shorter for Titan S than for hand instruments. Based on the results of this study, it may be concluded that, in patients with moderately advanced periodontitis, periodontal healing after scaling with the Titan S and hand instruments is comparable.

Adult↗

PubMed1987

Carbamate ester derivatives as potential prodrugs of the presynaptic dopamine autoreceptor agonist (-)-3-(3-hydroxyphenyl)-N-propylpiperidine.

Twenty derivatives bearing substituents on the phenolic function of (-)-3-(3-hydroxyphenyl)-N-propylpiperidine [(-)-3-PPP] were synthesized and tested as prodrugs. The carbamate ester derivatives were found to be the most suitable prodrugs, and especially the 4-isopropylphenylcarbamate 20 was capable of escaping the first-pass metabolism and still generating high plasma levels of the parent compound. Four hours after an oral dose of 100 mumol/kg to rats, a plasma level of 2400 nmol/L of (-)-3-PPP was detected by an HPLC method. This was 90 times the level reached after 4 h (27 nmol/L) when (-)-3-PPP itself was given orally at the same dose.

Animals↗

PubMed1987

On the age-dependent association between cancer of the breast and of the endometrium. A nationwide cohort study.

The association between breast and endometrial cancer was investigated in a cohort consisting of 60,065 subjects (99% of all women in whom a first breast cancer was diagnosed in Sweden in 1960-63 and 1968-81). Complete follow-up until 1981 revealed a total of 260 endometrial cancers, as against an expected number of 151.1 (relative risk (RR) = 1.72; 95% confidence limits (CL) 1.46; 1.87). RR increased steadily from close to unity in women younger than 50 at breast cancer diagnosis to 2.40 (CL 1.97; 2.93) in those 70 years of age and older. The excess number of endometrial cancers occurred primarily during the first five years of follow-up (RR = 2.07; CL 1.79; 2.38). A common causal agency for breast and endometrial cancer is more likely to lie in environmental than in genetic factors and other observations in the same population do not support that such factors are related to characteristics of the women's reproductive histories.

Adult↗

PubMed1987

Low plasma selenium as a risk factor for cancer death in middle-aged men.

In a population study, 10,000 men (aged 46-48 years) were invited to a health screening program. At follow-up, which was up to eight years later, 61 subjects had died from cancer; from 35 of these subjects, plasma samples were available that were obtained at the initial screening. These samples, together with samples from two living controls for each case, were analyzed for selenium, retinol, cholesterol, triglyceride, and a number of plasma proteins. Plasma selenium was significantly lower (p less than 0.05) in cases than in controls (means: 1.06 vs. 1.12 mumol/l). The proportion of cases increased significantly from the highest to the lowest quintile of plasma selenium, and the relative risk for cancer death was 3.8 times higher in the lowest quintile compared with the highest. Mean plasma retinol was similar in cases (2.53 mumol/l) and controls (2.56 mumol/l). Cases and controls also had similar values for plasma cholesterol, triglyceride, uric acid, apolipoprotein B, orosomucoid, prealbumin, retinol-binding protein, and beta 2-microglobulin. Apolipoprotein AI in plasma was lower among cases (p less than 0.025). Cases smoked significantly more than controls did (p less than 0.05). Data indicate that low plasma selenium was a risk factor for cancer death in middle-aged men who lived in the same area. Further studies are necessary to establish whether differences in selenium intake, selenium metabolism, or other factors related to selenium are responsible for the relations observed. At present, the available data do not justify selenium supplementation programs in the whole population.

Apolipoprotein A-I↗

PubMed1987

Health promotion policy in Sweden: means and methods in intersectoral action.

In Sweden different commissions have been working on legislation, prevention programmes and financing, and have aimed at implementing the Health For All strategy at national level. National programmes for cardiovascular diseases, cancer, accidental injuries, etc were established by parliamentary resolution in 1985. The role of health education has been extended: from the earlier concern with matters of individual lifestyle the focus has shifted towards motivating the community as a whole to take an active interest in its health. There is good public support in the areas of legislation, knowledge and awareness, international development (WHO), and public policy. Despite the existence of legislation, strong official policy and a good organizational structure, strong efforts are still needed to turn health promotion into general practice. National, regional and local bodies as well as non-governmental and private organizations are showing an increasing interest in health promotion. Health promotion strategies are used in traditional fields such as alcohol and smoking as well as other sectors such as education, employment, culture, social welfare, town and house planning, transport and environmental protection. There has never been such a positive basis for the further development of health promotion policy in Sweden though there are a number of potential conflicts and problems related to knowledge, organization, attitudes, financing, distribution of power, etc. These are outlined broadly as "The organizational trap", "Modification or revolution?" and "Individual or public responsibility for health?".

Government Agencies↗

PubMed1987

Clodronate treatment in patients with malignancy-associated hypercalcemia.

The possibility of reducing symptomatic hypercalcemia and of maintaining total serum calcium concentrations less than 2.8 mmol/l with clodronate (dichloromethylene bisphosphonate) was evaluated in 28 patients with various types of malignant tumors. Four episodes of hypercalcemic crisis with mean serum calcium concentrations of 4.43 mmol/l were controlled within 4-6 days of intravenous clodronate (4 mg/kg BW/day). This was accompanied by a moderate increase in serum creatinine values which, however, returned to pretreatment levels after therapy withdrawal in all but one case. Oral clodronate successfully reduced a mean serum calcium concentration of 3.16 mmol/l in 22 out of 25 patients after 3-12 days (800-3,200 mg/day). After reversal of the hypercalcemias oral clodronate controlled the serum calcium concentration for up to 42 weeks in six out of 15 patients After discontinuation of initial therapy five of seven recurrent hypercalcemias were successfully treated with oral or intravenous clodronate. Hypocalcemia and subjective side-effects were uncommon. It is concluded that clodronate is a valuable clinical tool in the management of patients with malignancy-associated hypercalcemia.

Administration, Oral↗

PubMed1986

Serum estrogens and androgens in women with endometrial carcinoma.

Fifty-two postmenopausal women with newly diagnosed endometrial carcinoma and 58 postmenopausal age-matched controls were studied concerning serum levels of estrone, total estrone, estradiol, androstenedione, testosterone, dehydroepiandrosterone and its sulphate, sex steroid hormone binding globulin, follicle stimulating hormone, and luteinizing hormone. The patients had a higher mean serum level of estradiol (P = 0.006) and a lower level of follicle stimulating hormone (P = 0.001) than the controls and the significant differences remained after the number of years since the menopause and body index had been taken into account. As the serum levels of steroid hormone binding globulin tended to be lower among patients than among controls (P = 0.084), the difference in the biological effect of estradiol between the two groups was probably greater than the difference in serum concentrations would indicate. No significant difference in the ratio of estrone to androstenedione or in the mean serum level of androstenedione was found between patients and controls. These data support the role of estrogen in the etiology of endometrial carcinoma.

Aged↗

PubMed1986

Reliability of endometrial cancer diagnoses in a Swedish Cancer Registry--with special reference to classification bias related to exogenous estrogens.

In this study, various qualitative aspects of endometrial cancer diagnoses were critically evaluated regarding cases included in the Swedish Cancer Registry from the Uppsala Health Care Region. By comparing the number of such cases in the registry with cases reported directly from the departments of pathology and of gynecological oncology in the same region, it was found that approximately 5% of all incident cases had not been notified to the registry. An independent histopathological review of the original specimens showed that almost 9% of the cases did not represent an endometrial neoplastic lesion, the majority of these being reclassified as uterine sarcoma. The review also revealed the problem of a diagnostic bias that might arise in connection with estrogen exposure, in that a significantly higher proportion of the cases observed in a cohort of women who had received estrogen prescriptions were reclassified as a premalignant endometrial lesion than of the cases from the background population without estrogen exposure (33% versus 10%). Additional independent reviews of cases showing discordant diagnoses in the primary review indicated variability in diagnostic criteria among pathologists. It is concluded that when cancer registry data are employed in epidemiological studies of endometrial cancer, the use of additional sources of case recruitment is desirable in order to obtain a complete material; also that an independent histopathological review is necessary to standardize diagnostic criteria and thereby to avoid a classification bias.

Estrogens↗

PubMed1986

Menstruation span--a time-limited risk factor for endometrial carcinoma.

A case-control study was undertaken to investigate the influence of reproductive factors on the risk of developing endometrial carcinoma. The study comprised 254 women with newly diagnosed endometrial carcinoma, resident in a defined geographical area, and 254 age-matched population controls. Nulliparity and late menopause were positively associated with endometrial carcinoma. Each additional full-term pregnancy resulted in a decrease in the risk by 16%. The importance of parity and menopausal age decreased with increasing life span, and in women older than 69 years these two variables did not discriminate significantly between cases and controls. The calculated number of years of menstruation (the "menstruation span") was used as a combined measure of the impact of parity, age at menarche and age at menopause on the risk of developing endometrial carcinoma. The patients had a significantly longer mean menstruation span than the controls (33.6 versus 31.2 years; p less than 0.001) and a longer span than 39 years gave a 4.2 times higher risk than one shorter than 25 years. It is suggested that the total length of time for which a woman is exposed to unopposed estrogen is important and that the effect of this hormonal influence is time-limited.

Adolescent↗

PubMed1986

Leiomyomatosis peritonealis disseminata.

Leiomyomatosis peritonealis disseminata (LPD) is a rare condition characterized by multiple subperitoneal spread of nodules, giving the clinical impression of a widespread malignant tumor. The histopathology of LPD is that of a benign leiomyoma, probably originating from the multipotent subcoelomic mesenchymal cells. Two new case reports are presented here, suggesting that some cases of LPD are wrongly classified as metastasizing leiomyosarcoma. As the prognosis in LPD is favorable, it is of great importance to establish the correct diagnosis. When both the pathologist and the clinician become aware of the multipotentiality of the mesothelium and the adjacent stroma and thereby the multifocal character of the lesions, some of the diagnostic problems might be overcome.

Adult↗

PubMed1986

Climacteric symptoms and estrogen replacement therapy in women with endometrial carcinoma.

A case-control study was undertaken to investigate the influence of exogenous estrogens and climacteric symptoms on the risk of developing endometrial carcinoma. The study comprised 254 women with newly diagnosed endometrial carcinoma, resident in a defined geographical area, and 254 age-matched population controls. Treatment with estrogens for 4 years or longer was significantly more common among patients than among controls (odds ratio = 4.5; 95% confidence limit (CL) = 1.2-17.3). A history of climacteric symptoms was reported by significantly fewer patients than controls (odds ratio = 0.5; 95% CL = 0.3-0.7) and this difference was shown to be independent of weight. The decrease in risk associated with climacteric symptoms was limited to women younger than 70 years.

Adult↗

PubMed1985

Endometrial polyps and hyperplasia as risk factors for endometrial carcinoma. A case-control study of curettage specimens.

As part of a comprehensive case-control study, the impact of previous endometrial pathology on the risk of developing endometrial carcinoma was investigated. The study comprised 254 consecutive women with histopathologically confirmed cancer of the uterine body in a well-defined population, and their age-matched controls. Ninety-eight (39%) of the patients and 81 (32%) of the controls had previously undergone endometrial curettage. More than one previous curettage was positively associated with endometrial carcinoma (odds ratio = 2.5; 95% CL = 1.4-4.5). Endometrial abnormalities in previous curettage specimens occurred significantly more often among carcinoma patients (57%) than among controls (25%) (odds ratio = 4.0; 95% CL = 2.0-8.0). Twelve patients, but no controls, had adenomatous hyperplasia and this hyperplasia antedated the cancer diagnosis by a mean of 4.6 years. Endometrial polyps were present significantly more often in patients (20%) than in controls (10%) (odds ratio = 3.4; 95% CL = 1.3-9.3). The present results suggest that both of these conditions are risk factors for endometrial carcinoma. Among women who had undergone endometrial curettage more than 4 years after the menopause, 19 out of 30 patients, but none out of 7 controls, showed abnormality in the curettage specimens. Postmenopausal women with endometrial abnormality should thus be regarded as being at risk of developing endometrial carcinoma.

Age Factors↗

PubMed1985

The inhibitory effect of tobacco smoke compound on ciliary activity.

The embryo chicken trachea was used as an in vitro model to study the ciliotoxicity of the volatile part of the particulate phase of cigarette smoke condensate (CSC). We also report on the ciliotoxicity of 11 phenols belonging to the semi-volatile fraction. The particulate phase of CSC was divided into a semi-volatile (SV) and a non-volatile (NV) fraction. The toxicity of CSC, SV and NV was approximately the same, giving ciliostasis within 21-28 minutes at a concentration of 1 mg/ml. The SV-fraction, constituting 12 percent of the particulate phase, was further divided into 4 subfractions: acids, phenols, bases and neutrals. The neutral fraction was significantly (p less than 0.001) more toxic than any of the other fractions, giving ciliostasis after 17 minutes at a concentration of 1 mg/ml. Least toxic was the basic fraction, mainly consisting of nicotine. At a concentration of 3 mg/ml, the mean value for ciliostasis was 64 minutes. From the investigation of phenols it was found that alkylated phenols were more ciliotoxic than phenol. The toxicity was enhanced with increasing chain-length of the substituent, i.e. with increasing lipophilicity.

Animals↗

PubMed1984

An evaluation of the utility of four in vitro short term tests for predicting the cytotoxicity of individual compounds derived from tobacco smoke.

An evaluation of results obtained earlier and now complemented to provide information on the activity of 305 compounds in four in vitro tests has been undertaken. Biological data based on the effects of these compounds on cell multiplication, oxidative metabolism, ciliary activity and membrane permeability are compared with a view to clarifying intersystem similarities and differences and, on the basis of a mean activity parameter, evaluating structure-activity and functionality-activity relationships. High mean activity is observed for 59 compounds, of which 18 are phenols, 14 aldehydes, 8 N-heterocyclics, 7 alcohols and 5 hydrocarbons. The medium and low mean activity groups comprise 105 and 131 members, respectively, and both include representatives of all functionalities examined. Delineation of the 305 compounds using 45 descriptors, and computer-assisted matching of these and any combination of them against the mean activity showed the most toxic single descriptor group to be terpenoids followed by indoles and naphthalenes, and the most toxic two-descriptor group to be alpha,beta-unsaturated carbonyls followed by n-alkyl alcohols, aldehydes and acids. Examination of intersystem similarities and differences, using a high-medium-low scale, shows that all four systems give the same result for 35 percent of the compounds, three systems for 41 to 48 percent of the compounds, and two systems for 53 and 64 percent of the compounds. Of all compounds, 16 percent exhibit a high activity in one system and a low activity in the other three, or vice versa. Nearly half of these discrepancies are caused by the membrane permeability system showing diverging results, while none of them are related to the brown fat cell system. The last test system is found to best represent the mean activity obtained from the four systems and the one of choice if reducing the number of tests from four to one.

Cells, Cultured↗

PubMed1984

Evaluation of the biological activity of cigarette-smoke condensate fractions using six in vitro short-term tests.

The biological activity of the volatile part of the particulate phase of cigarette-smoke condensate, the semivolatile fraction, has been examined, since the constituents of this material are accessible to selective filtration. Such a process offers a possibility to reduce the biological activity of total cigarette smoke without appreciably affecting the taste. Cigarette-smoke condensate, obtained from domestic American blend type cigarettes, was therefore separated into a nonvolatile and a semivolatile fraction, and the latter was fractionated by liquid-liquid extractions into four subfractions; acids, phenols, bases, and neutrals. The biological activity of these fractions was investigated using six in vitro short-term tests, of which two, the Ames test and the induction of sister chromatid exchanges, provided information on their genotoxicity, and the other four provided information on their cytotoxicity by measuring inhibition of cell growth, inhibition of oxidative metabolism, membrane damage, and ciliotoxicity. Sister chromatid exchanges were found to be induced by the total condensate, the nonvolatile and the semivolatile fractions, and the subfractions derived from the semivolatile fraction, except the bases. The Ames test showed the total condensate and the nonvolatile fraction to contain direct-acting base-pair mutagens as well as indirect-acting frameshift mutagens. While the semivolatile fraction was found nonmutagenic, two of its subfractions, acids and phenols, were shown to contain base-pair mutagens, which did not require metabolic activation. The total condensate and the nonvolatile and semivolatile fractions showed similar activity in the four cytotoxicity tests. Of the semivolatile subfractions, the acids and the phenols exhibited the highest activity and the bases the lowest; the toxicity observed for the neutrals varied with the test system used.

Animals↗

PubMed1984

Long-term survival in endometrial cancer with special reference to age as a prognostic factor.

Long-term survival was evaluated in 13 586 patients with cancer of the endometrium, constituting 97% of all cases diagnosed in Sweden 1960-1978. Survival rates corrected for the expected mortality revealed that age at diagnosis is an important predictor of prognosis, with a constant trend towards a more favourable course in younger women. Thus, the cumulative relative 15-year survival rates +/- 95% confidence limits were 90 (86.1-93.7)%, 89 (87.4-91.3)%, 72 (68.9-74.3)%, 50 (44.9-54.7)% and 32 (18.3-45.6)% at ages 35-44, 45-54, 55-64, 65-74 and 75+ years respectively. Patients younger than 55 years deviated from the general pattern by having an excellent survival and virtually no excess mortality after 7 years of observation.

Adult↗