Biomedical subjects

C Lindholm

Publications and source records attributed to C Lindholm.

At least 91 records · Page 5Linked to original sources

PubMed1994

A cost-effectiveness study of leg ulcer treatment in primary care. Comparison of saline-gauze and hydrocolloid treatment in a prospective, randomized study.

OBJECTIVE: The majority of leg ulcer patients in Sweden are managed by primary health care personnel. To compare, in a primary care setting, the healing results and the expenses of two commonly used wound dressings for leg ulcers. DESIGN: Thirty patients with leg ulcers of venous or mixed venous/arterial aetiology were randomized to treatment with saline-soaked gauze or with the hydrocolloidal dressing [HCD: DuoDERM (ConvaTec, A Bristol-Myers Squibb Company, Princeton)]. All patients were bandaged with the same compression of low-stretch-type [Comprilan (Beiersdorf AG, Hamburg)]. SETTING: Vårdcentralen Marieberg, Primary Health Care Centre, Motala, Sweden. OUTCOME MEASURES: Healing/reduction of ulcer area, pain, costs for material, nursing time, kilometres driven were registered during a six-week period. RESULTS: Two patients dropped out of the study, one in the gauze-group due to erysipelas, and one in the HCD-group for social reasons. A total of 1234 dressing changes were analysed. Costs for material were similar in the two groups. When the total care including nursing- and travelling time and kilometres driven were analysed, the mean cost for treatment with gauze dressings was 4126 Swedish Kronor (SEK), and with HCD, 1565 SEK. Seven patients in the HCD-group and two in the gauze-group healed during the study. The reduction of the ulcer area was 19% in the gauze-group and 51% in the HCD-group (p < 0.16). CONCLUSION: The total care, analysed in an authentic clinical setting, must be considered when different wound-care methods are discussed. In this study the use of HCD showed lower costs than use of gauze-dressings. As regards healing there was a tendency to improved healing with HCD, but no significant difference. Patients in the HCD-group reported significantly less pain at dressing changes (p < 0.003) than patients in the gauze-group.

Aged↗

PubMed1993

Detection of whole chromosomes in micronuclei of cytokinesis-blocked human lymphocytes by antikinetochore staining and in situ hybridization.

The effect of cytochalasin B (Cyt-B; 3 and 6 micrograms/ml; for the last 28 h) on micronuclei (MN) was studied in 72-h purified lymphocyte cultures of three male donors. The frequency of MN was much higher in multinucleate cells (mean 100-204 MN per 1000 cells) than in binucleate cells (mean 8.2-21.0 MN per 1000 cells), tetranucleate cells containing more MN than trinucleate cells. The presence of whole chromosomes in the MN was studied in two separate experiments by immunofluorescence using antikinetochore (CREST) serum and by a centromeric alphoid DNA oligomer probe (in situ hybridization, ISH). In the tri- and tetra-nucleate cells produced by Cyt-B, MN were clearly more often kinetochore-positive (K+) (mean 82-86%) and centromere-positive (C+) (mean 73-83%) than in mononucleate cells of cultures containing no Cyt-B (mean 63% for CREST and 50% for ISH), indicating that most of the excess MN in the multinucleate cells were due to whole chromosomes. The binucleate lymphocytes had about as high prevalence of K+MN (mean 79-84%) as the tri- and tetra-nucleate cells, despite their low MN count. Also in the ISH analysis, the majority of MN in binucleate cells were positively stained (mean 58-62%). If it is assumed that the extra labelled MN are due to Cyt-B, the present findings suggest that Cyt-B could be responsible for approximately 45-57% (CREST data) or approximately 17-23% (ISH data) of MN in binucleate cells.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1993

Hormone anabolic/catabolic balance in female endurance athletes.

The anabolic/catabolic hormone balance in 13 female endurance athletes was studied during basal conditions by comparing their serum concentrations of androgenic and catabolic steroids, growth hormone, insulin-like growth factor 1 (IGF-1) and insulin with corresponding values in 15 matched sedentary controls. Higher cortisol and lower levels sex hormone-binding globulin (SHBG) were found in the athletes, and these differences were enhanced depending on the degree of menstrual disorders. There was a negative correlation between cortisol and SHBG levels. No differences were found in concentrations of androgens, IGF-1 and insulin. The results indicate a normal anabolic activity in oligomenorrheic athletes, but due to their distinct hypercortisolism, the anabolic/catabolic hormone balance is changed to a predominantly catabolic state.

Adult↗

PubMed1993

Micronucleus assay in lymphocytes as a tool to biomonitor human exposure to aneuploidogens and clastogens.

The analysis of micronuclei (MN) in cultured human lymphocytes is, in principle, able to detect exposure to clastogens and aneuploidogens alike. There is, however, no clear evidence from human biomonitoring studies or animal experiments showing that in vivo exposure of resting lymphocytes to an aneuploidogen could actually be expressed as MN in cultured lymphocytes. In vitro, a pulse treatment of human lymphocytes with vinblastine, an aneuploidogen, did result in MN induction even if performed before mitogen stimulation, although a much more pronounced effect was obtained in actively dividing lymphocyte cultures. On the other hand, it is probable that a considerable portion of "spontaneous" MN contain whole chromosomes, their contribution increasing with age. It also seems that cytochalasin B, used for the identification of second cell cycle interphase cells in the MN assay, is able to slightly increase the level of MN with whole chromosomes. If MN harboring chromosome fragments represent a minority of the total MN frequency, there may be difficulties in detecting a weak effect in this fraction of MN against the background of MN with whole chromosomes. This would reduce the sensitivity of the assay in detecting clastogens, unless MN with whole chromosomes and chromosome fragments are distinguished from each other. That a problem may exist in sensitivity is suggested by the difficulty in demonstrating MN induction by smoking, an exposure capable of inducing chromosome aberrations. The sensitivity of the lymphocyte MN assay could be increased by detecting kinetochore or centromere in MN, or by automation, allowing more cells to be analyzed.

Aneuploidy↗

PubMed1993

Quality of life in chronic leg ulcer patients. An assessment according to the Nottingham Health Profile.

Chronic leg ulcer is a disease of long duration, occurring predominantly in elderly people. Traditionally, little interest has been devoted to the study of the impact of this disease on life quality. In the present study the Nottingham Health Profile (NHP) was used to assess disease influence on six areas of daily life, namely: pain, physical mobility, sleep, energy, emotional reactions and social isolation. Standard questionnaires were distributed to patients with chronic leg ulcers of venous, arterial or mixed venous-arterial origin, treated at the Department of Dermatology. Complete data were obtained from 125 patients. The disease had a marked impact on the patient's subjectively perceived health. Males exhibited remarkably elevated scores, compared to the normative scores for men, especially in the areas of pain, emotional reactions, social isolation and physical restrictions. For women the impact of leg ulcer disease, although obvious, seems much less marked than for males. An exceptionally long median duration of leg ulcer disease was found among shop-assistants. It is possible that preventive measures should be undertaken in this group. The duration of leg ulcer disease did not seem to influence the quality of life. Patients with long disease duration in fact reported fewer problems than those with shorter duration, suggesting adaptive mechanisms. This study indicates that male leg ulcer patients should be more closely observed for symptoms of emotional stress, pain, social isolation and impaired physical mobility. More efforts should be made to alleviate pain. Above all this study underlines the importance of considering not only the ulcer but the whole patient.

Adult↗

PubMed1992

Charisma, crowd psychology and altered states of consciousness.

This paper argues that an interpretive meaning-centered analysis is not adequate for understanding collective behavior that is outside the range of calculating rationality. Alternative approaches to collective irrational action are drawn from the work of Weber and Durkheim, as well as from the crowd psychologists Le Bon and Tarde. These approaches are then illustrated in a short analysis of the trajectories and recruitment techniques of two contemporary American religious annunications: est and Scientology, and the findings applied to the general social formation.

Consciousness↗

PubMed1992

Identification of single amino acid substitutions in the staphylococcal nuclease protein that enhance and diminish T cell clone recognition of naturally processed peptides.

It has been inferred that residue changes that affect T cell recognition of synthetic peptides will have a similar effect in the intact protein. However, since small peptides do not require antigen processing it is possible that residue changes in synthetic peptides will not have an equivalent effect in the intact protein. Mutant proteins of staphylococcal nuclease (Nase) and 15mer synthetic peptides with corresponding substitutions were compared to determine if residue changes within an immunodominant epitope have an effect on the generation of naturally processed peptides. Five different substitutions in the synthetic peptide resulted in loss of reactivity of individual Nase-specific clones. When the same single amino acid changes were made in the intact protein, the naturally-processed peptides were also unable to stimulate the Nase-specific clones. However, two other substitutions in the synthetic peptide were stimulatory for a T cell clone even though the same changes in the intact protein were non-stimulatory. These results suggest that certain residue changes affect recognition of the naturally processed peptide but not the synthetic peptide with the same amino acid change. In addition, these results demonstrate that the effects of amino acid substitutions in synthetic peptides on T cell recognition may not always reflect the effects of these substitutions in the intact protein. Substitutions located outside Nase-specific T cell epitopes were also examined. Thirty different mutant proteins were all stimulatory. Moreover, a number of these mutants proteins were 50- to 100-fold more efficient in their stimulatory capacity than the native Nase protein.(ABSTRACT TRUNCATED AT 250 WORDS)

Amino Acids↗

PubMed1992

Leg and foot ulcers. Nursing care in Malmö, Sweden.

Questionnaires concerning nursing care of leg and foot ulcer patients in three major care-giving sectors of the national health service, namely the Department of Dermatology, general hospital wards/clinics, and primary care, have been analysed. The overall response rate was 88% (primary care: 100%). Forms regarding 193 patients with leg ulcers and 64 patients with foot ulcers were analysed. Substantial differences in nursing care were noted between the three sectors. In 55% of the leg ulcers and 45% of the foot ulcers fibrin slough was present in the ulcer. Black, necrotic tissue was present in 8% of the leg ulcers and 22% of the foot ulcers. Profuse ulcer-exudation was most commonly reported for leg ulcer patients treated at the Department of Dermatology, while the majority of foot ulcers had only a mild exudation. Frequency of dressing changes varied between 1.4 times/week for leg ulcers at the Department of Dermatology and 9.2 times/week (foot ulcers 11.6) at general hospital clinics. Local wound dressings were exclusively chosen by physicians at the Department of Dermatology, mainly by physicians at general hospital clinics, and equally often by physicians and nurses in primary care. Time since last evaluation of the ulcer by a physician varied. At the general hospital clinics, 89% of the patients with leg ulcers had been seen by a physician within the last 2-month period. At the Department of Dermatology, 89% and in primary care 61% of the patients were examined within this period. 11% of the patients in primary care had never consulted a physician for their ulcers.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

PubMed1992

A demographic survey of leg and foot ulcer patients in a defined population.

By means of a questionnaire sent to all medical units in Malmö, including primary care, homes for the elderly, and industrial health clinics, 275 patients with leg and foot ulcers were identified. With a population of 232,908 in Malmö, this corresponds to a prevalence of 0.12%, which is lower than reported by others. Since the response rate was high (88% total, Primary Care: 100%), the prevalence of 0.12% is, however, believed to be real and might be explained by the urban area investigated, with easy access to care and proximity to one somatic hospital. 50% of the patients with leg and foot ulcers were treated in Primary Care, and 30% of the leg ulcer patients were treated at the Department of Dermatology. 88% of leg and foot ulcer patients were over 75 years of age. Median age was 79.5 years, with 80 for women and 76.5 for men. In Primary Care the median age was 82. There was a predominance of women in the study population with an overall sex ratio of 3:1. A higher proportion of patients living alone was found in Primary Care. The etiology of the ulcers was considered to be "unknown" or "other" or else no statement was given in 36% of the leg ulcer- and 22% of the foot ulcer patients. This might reflect an overall uncertainty about the underlying etiological cause. Medially and laterally located leg ulcers were reported equally often, but there was also a great proportion of wholly or partially circumferential ulcers. 76% of the foot ulcers were located on the toes.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1991

Induction of micronuclei and anaphase aberrations by cytochalasin B in human lymphocyte cultures.

The frequency of micronucleated cells in isolated 72-h human lymphocyte cultures treated with cytochalasin B (Cyt-B; 1.5-6 micrograms/ml for the last 28 h) was 9-21 times higher (mean 14.6 times) among multinucleate than binucleate cells. At 3 micrograms/ml, the concentration of Cyt-B originally recommended for the human lymphocyte micronucleus assay, the frequency of micronucleated multinucleate cells was 8.5%, while 0.7% of the binucleate cells had a micronucleus. Although no dose-dependent induction of micronuclei could be observed for either of the cell types, increase in the concentration of Cyt-B was associated with a decrease in the ratio of multinucleate to binucleate cells. Treatment with Cyt-B (1.5-12 micrograms/ml) increased the frequency of anaphase cells with aberrations, especially lagging chromatids. This finding was explained by a dose-dependent increase in multipolar (greater than or equal to 3 poles) divisions which had a high frequency of anaphase aberrations (39-53%), irrespective of the concentration of Cyt-B. Bipolar anaphases did not show a significant increase in aberrant cells, although a suggestive dependence on the concentration of Cyt-B was observed. The findings indicate that the high frequency of micronuclei in multinucleate lymphocytes produced by Cyt-B is due to mitotic errors arising when bi- (and multi-) nuclear cells divide. To avoid possible artifactually high micronucleus frequencies due to inclusion of cells that have divided greater than or equal to 2 times in the presence of Cyt-B, it is recommended that, in the human lymphocyte micronucleus assay using the cytokinesis-block method, the cell culture time is reduced to minimize the frequency of such cells and that only good preparations and regularly shaped binucleates are included in the analysis.

Adult↗

PubMed1991

Determination of 6-thioguanine resistant lymphocytes in human blood by immunohistochemical antibromodeoxyuridine staining.

An immunohistochemical method for the determination of 6-thioguanine resistant (TGr) lymphocytes in human blood samples has been developed. The new technique is a modification of the autoradiographic assay and uses labelling of DNA synthesizing cells by bromodeoxyuridine (BrdU) instead of tritiated thymidine. The label is detected immunohistochemically by using a monoclonal antibody against BrdU in single-stranded DNA. Thawed cryopreserved isolated mononuclear cells are cultured with (TG cultures) and without (control cultures) TG for 40 h, the last 16 h with BrdU. The cells are harvested, fixed and put on microscopic slides; for the TG cultures, all material is used, while slides from the control culture are prepared at a dilution of 1:300. The immunohistochemical staining of the slides involves denaturation of DNA in formamide, incubation with anti-BrdU-DNA antibody, followed by a secondary antibody conjugated with peroxidase and staining with diaminobenzidine. Nuclei that have incorporated BrdU appear brown while all other material remains unstained. The number of all labelled nuclei is scored similarly in control and TG slides and the frequency of TGr lymphocytes is obtained by dividing the number of labelled nuclei in TG slides with that (multiplied by the dilution factor) in control slides. The anti-BrdU method will much simplify and speed up the microscopical evaluation of the TG variants and is very suitable for automation.

Bromodeoxyuridine↗

PubMed1991

Regional hyperthermic perfusion with melphalan after surgery for recurrent malignant melanoma of the extremities. Swedish Melanoma Study Group.

A prospective randomized trial testing regional hyperthermic perfusion with melphalan has been conducted. Sixty-nine patients with recurrent malignant melanoma of the extremities were randomly allocated to surgery (36 patients) or surgery plus regional perfusion (33 patients). Prognostic variables concerning primary tumor as well as the recurrent disease were evenly distributed in the groups, excluding any bias in the randomization. Median tumor-free survival after randomization was 17 months in the perfusion group and 10 months in the control group. There were 15 locoregional recurrences in the perfusion group and 24 in the control group. The tumor-free survival curve was significantly (P = .044) better for the perfusion group than for the control group. Median survival time after randomization was 57 months in the perfusion group and 35 months in the control group. This difference was not significant. One patient died within 1 month after perfusion of pulmonary embolism. Regional hyperthermic perfusion after surgery of recurrent malignant melanoma should only be recommended in prospective and controlled trials, until its value has been proven in several randomized studies.

Adult↗

PubMed1990

Single cell DNA cytophotometry in clinical stage I malignant melanoma. Relationship to prognosis.

Histological sections of 50 clinical stage I cutaneous melanomas were analyzed by single cell DNA cytophotometry. Forty-two percent of the melanomas had diploid modal values. Ploidy was not significantly related to the level of invasion, melanoma thickness or prognosis. These results are contradictory to published data from flow cytophotometry which, however, differ inter alia concerning patient materials and follow-up times. Mean nuclear area was in our study significantly correlated to the prognosis.

Adult↗

PubMed1989

Flow DNA-cytometric findings of paraffin-embedded primary cutaneous melanomas related to prognosis.

In a retrospective study flow cytometry was performed in 82 paraffin-embedded clinical stage I cutaneous melanomas. A significant correlation of ploidy to melanoma thickness was found. Using a log rank test ploidy was found significant for prognosis. However, using the Cox's proportional hazard test the influence of ploidy vanished and melanoma thickness or Clark level of invasion together with sex and location were the factors most important for prognosis.

Adult↗

PubMed1989

Characterization of neoplastic and reactive cells in T-cell lymphomas with cytogenetic, surface marker, and DNA methods.

Three patients with T-cell lymphoma were studied with a combined cytogenetic-immunological analysis (MAC) as well as by Southern blotting analysis. The MAC method, which allows simultaneous study of both chromosomes and immunophenotype of a mitotic cell, revealed that in each case the karyotypically abnormal and, therefore, neoplastic cells originated from different stages of T-cell maturation. In one case the abnormality was seen in cells expressing CD3 and CD10, in the second in cells expressing CD3 and CD8, and in the third case in cells expressing CD4 but not CD3. Mitoses were frequent also in non-neoplastic cells, but these mitoses were normal. Southern blotting analysis revealed TCR beta rearrangements in all patients. In addition, one patient displayed TCR gamma rearrangement, and one patient a rearrangement in the IgH joining region.

Aged↗

PubMed1988

Unique display of a pathologic karyotype in Hodgkin's disease by Reed-Sternberg cells.

The clonality of Reed-Sternberg cells is still a matter of controversy. In Hodgkin's disease, these cells rarely constitute more than 2% of all cells in tissue biopsies of lymph node lesions, the rest being a large collection of various reactive cells. To determine in which cells the abnormal karyotype occurs, we studied two patients with Hodgkin's disease by a cytogenetic method allowing simultaneous analysis of cell morphology, immunologic phenotype, and karyotype in the same mitotic cell. The Ber-H2 (CD30) and Leu-M1 (CD15) monoclonal antibodies were used to identify mitotic Reed-Sternberg cells. In 24-48-hour cultures of lymph node cells from Hodgkin's lesions, there was a mixture of cells with an abnormal clonal karyotype and a normal karyotype. The abnormal clonal karyotype was restricted to Ber-H2- and Leu-M1-positive cells, i.e., the Reed-Sternberg cells. In keeping with these findings, most of the clonal atypical karyotypes occurred in kappa- and lambda-positive large cells, i.e., Reed-Sternberg cells. Mitotic cells with T markers (CD3,4,8) or B markers (CD22) had the normal karyotype. There were no mitoses in cells expressing the antigens recognized by Leu11 (CD16) or Leu11 + Leu7. These findings provide strong evidence suggesting that in Hodgkin's disease only the Reed-Sternberg cells possess a clonal karyotypic abnormality and thus are most probably the only neoplastic component in Hodgkin's disease.

Adult↗

PubMed1988

A method combining morphological, immunocytochemical and chromosomal examinations of the same cell in the study of lymphoproliferative diseases.

6 cases of different lymphoproliferative diseases were studied with the new MAC (Morphology-Antibody-Chromosome) method in order to find out 1) if the abnormal karyotype is confined to the monoclonal cell population, 2) if there are, within this clone, also cells with a normal karyotype, and 3) if the method can help the pathologist to diagnose malignant lymphoproliferative diseases. The MAC method allows a simultaneous study in the same metaphase cell of the karyotype, surface markers, and some morphological features. In all cases in which a monoclonal cell proliferation was detected immunohistologically, the MAC examination showed a chromosomal abnormality for the same light chain as was detected in immunohistology, but not in other cells. In all but a single case, all mitotic cells belonging to the clonal cell proliferation had an abnormal karyotype. In this case with lambda clonality, 2/8 lambda-positive mitoses had a normal karyotype. However, all the normal mitoses occurred in small lymphocytes whereas the abnormal mitoses were seen in large blastic cells. In 1 case, the MAC method helped in confirming the diagnosis of malignant lymphoma (nodular small cleaved cell type). Especially in lymphomas composed of a mixed cell population, the MAC method makes it possible to find out which cell types have an abnormal karyotype and which have a normal karyotype.

Adult↗

PubMed1988

Karyometric findings and prognosis of stage I cutaneous malignant melanomas.

A material consisting of 82 stage I cutaneous melanomas was analysed clinically, histopathologically and karyometrically. High age, deep Clark level of invasion and thick melanomas were associated with a negative prognosis. There was a good correlation between the nuclear area and the melanoma thickness. By applying Cox's proportional hazard method to clinical, histopathological and karyometric data, it was demonstrated that karyometry provided both prognostic and biological information. Both a large variation (percentile 90-percentile 50) in nuclear area and a large standard deviation of form factor was related to a negative prognosis (p less than 0.0003 and p less than 0.04 respectively).

Adult↗