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Biomedical subjects

E Berg

Publications and source records attributed to E Berg.

At least 37 records · Page 2Linked to original sources

[Early postoperative complications after different methods of intestinal reconstruction in deep anterior rectum resection--a prospective study].

For the first period after low anterior resection and total mesorectal excision for rectal cancer, the colonic J-pouch is superior to the straight or lateroterminal anastomosis. Despite the simple technique and short stretch of sutures, the LTA is unsuitable due to the high postoperative morbidity and because the reconstruction functions poorly. If the expected anastomis is below 6 cm from the anal verge, i.e. 4 cm above the sphincter muscle, the colonic J-pouch is recommended.

Adult↗

Retinal Muller glia secrete apolipoproteins E and J which are efficiently assembled into lipoprotein particles.

We have shown that apolipoprotein E (ApoE) is synthesized by Muller cells, the major glial cell of the rabbit retina, and secreted into the vitreous after which it is taken up by retinal ganglion cells and rapidly transported into the optic nerve [Amaratunga et al., J. Biol. Chem. 271 (1996) 5628-5632]. In this report we demonstrate that the ApoE secreted by Muller cells in vivo and in culture is efficiently assembled into lipoprotein particles. Apolipoprotein J (ApoJ) is also synthesized by these cells and assembled into lipoprotein particles. The lipoproteins are triglyceride-rich and contain cholesterol esters and free cholesterol. They are heterogeneous, with densities between 1.006 and 1.18 and diameters between 14 and 45 nm. We discuss the possible role of these lipoproteins in supplying the needs of neurons for lipids, especially long axonal projection neurons such as retinal ganglion cells, which are vulnerable to age-related neurodegenerative diseases including Alzheimer's disease.

Animals↗

Mouse mastocytoma cells synthesize undersulfated heparin and chondroitin sulfate in the presence of brefeldin A.

In order to study the subcellular localization and organization of the enzymes involved in the glycosylation of the hybrid proteoglycan serglycin, mouse mastocytoma cells were metabolically labeled with [35S]sulfate or [3H]glucosamine in the absence or presence of brefeldin A. This drug is known to induce a disassembly of the proximal part of the Golgi complex, resulting in a redistribution of cis-, medial-, and trans-Golgi resident enzymes back to the endoplasmic reticulum, and to block the anterograde transport of proteins to the trans-Golgi network. Although the total incorporation of [3H]glucosamine into glycosaminoglycan chains was reduced to about 25% in brefeldin A-treated cells compared to control cells, both control cells and cells treated with brefeldin A synthesized heparin as well as chondroitin sulfate chains. Therefore, enzymes involved in the biosynthesis of both types of glycosaminoglycan chains seem to be present proximal to the trans-Golgi network in these cells. Chondroitin sulfate and heparin synthesized in cells exposed to brefeldin A were undersulfated, as demonstrated by ion-exchange chromatography, compositional analyses of disaccharides, as well as by a lower [35S]sulfate/[3H]glucosamine ratio compared to controls. In heparin biosynthesis, both N- and O-sulfation reactions were impaired, with a larger relative decrease in 2-O-sulfation than in 6-O-sulfation. Despite undersulfation, the heparin chains synthesized in the presence of brefeldin A were larger (30 kDa) than the heparin synthesized by control cells (20 kDa). The reduced [3H]glucosamine incorporation in brefeldin A-treated cells was partly due to decreased number of glycosaminoglycan chains synthesized, but also to the biosynthesis of chondroitin sulfate chains of smaller molecular size (8 versus 15 kDa in control cells). Brefeldin A had no effect on the glycosaminoglycan synthesis when used in a cell-free, microsomal fraction, indicating that brefeldin A does not interfere directly with the enzymes involved in the biosynthesis of glycosaminoglycans.

Animals↗

[Biofeedback].

The overall success rate of biofeedback in ano-rectal incontinence and chronic constipation is reported to be 50-92% and 35-90%, respectively. In patients with neurogenic incontinence, the results are poor. Biofeedback, in case of outlet obstruction, seems only to be useful if there is paradoxical contraction of the external anal sphincter and/or the puborectalis muscle during straining (anismus). Further investigations to select patients who would profit from this therapy are, therefore, necessary.

Anal Canal↗

Dentists' opinions on aspects of cast titanium restorations.

OBJECTIVES: The purpose of this paper was to study dentists' opinions regarding aspects of the clinical use of cast titanium restorations. METHODS: Since 1988 more than 10,000 cast titanium units of crowns and fixed partial dentures have been produced by the only dental laboratory that produces cast titanium restorations in Norway. A questionnaire on the clinical behaviour of such restorations was mailed to all 72 dental practitioners who were recorded in the computer file of this laboratory. RESULTS AND CONCLUSION: In the opinion of the 64 dental practitioners who completed the questionnaire, cast titanium is a useful supplement to conventional casting alloys, particularly because of its favourable cost. It has a satisfactory clinical behaviour, although there may be some problems related to technical and aesthetic aspects.

Attitude of Health Personnel↗

Validation of the Dental Fear Scale and the Dental Belief Survey in a Norwegian sample.

The aim of this study was to validate the Kleinknecht's Dental Fear Scale and the Getz's Dental Belief Survey in a Norwegian sample by 1) testing their ability to discriminate between fearful (n = 151) and regular (n = 160) patients, and 2) correlating them. Both instruments were highly reliable (Cronbach's alpha > 0.90). Between 81% and 95% of the fearful and regular patients were correctly assigned to their appropriate groups with both instruments. It may thus be concluded that both instruments are valid. Also, the correlation between the instruments was 0.68, indicating that they to a large extent seem to measure the same concept. The most important predictor items for both instruments were related to avoidance of dental treatment.

Adult↗

Monokine expression in Langerhans' cell histiocytosis and sinus histiocytosis with massive lymphadenopathy (Rosai-Dorfman disease)

Langerhans' cell histiocytosis (LCH) is a clonal proliferation of Langerhans cells (LC) showing histologically an abundant reactive infiltrate composed of macrophages and lymphocytes, as well as eosinophilic and neutrophilic granulocytes. Rosai-Dorfman disease (RDD) shows a sinusoidal accumulation of large histiocytic cells with an immunophenotype similar to LC of LCH. The histological picture of LCH is reminiscent of an inflammatory disorder and LC may produce cytokines and are influenced by these soluble factors. This study set out to establish the monokine expression pattern in LCH in comparison with those of RDD; dermatopathic lymphadenopathy, which also shows a proliferation of S100-positive dendritic cells; and LC in normal skin specimens. Isotopic in situ hybridization was used for the detection of transcripts of tumour necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6), and IL-1 beta, in some cases combined with immunohistology for the S100 protein or CD68. In all 11 tissue samples from eight patients, LC of LCH expressed TNF-alpha; in two cases IL-1 beta transcripts were additionally noted in some LC, whereas IL-6 was found in reactive cells. Large histiocytic cells of RDD expressed all three monokines, whereas minimal or no expression of these cytokines could be detected in interdigitating reticulum cells in dermatopathic lymphadenopathy. In two out of five normal skin samples, only TNF-alpha specific signals were observed in LC. These data suggest that histologically different lesions of the histiocytic/dendritic cell system display distinct cytokine profiles. The expression of monokines, which have been demonstrated to influence various functions of epidermal LC, may play a role in the pathogenesis of LCH. Systemic symptoms in RDD may be related to enhanced production of monokines in these lesions.

Child↗

Hardness, strength, and ductility of prefabricated titanium rods used in the manufacture of spark erosion crowns.

Depending on the size of the prepared tooth spark eroded and milled, Procera crowns (Nobelpharma AB, Göteborg, Sweden) are manufactured from one of five diameters of pure titanium rods. In this study microindentation hardness tests were performed on the outer 400 microns and center of 10 samples for each type of rod. Five tensile samples were also machined for each of the diameters and tested in tension in a universal testing machine. Cast titanium samples were similarly prepared and tested. Some significant differences in hardness and considerable differences in strength and ductility were identified between the prefabricated rods. In comparison, cast titanium was significantly harder and stronger but less ductile.

Analysis of Variance↗

High prevalence of sexually transmitted diseases in women with urinary infections.

OBJECTIVE: To determine the prevalence and factors associated with unrecognized sexually transmitted diseases (STDs) in women who had pelvic examinations and were subsequently released from the ED with a sole diagnosis of urinary tract infection (UTI). METHODS: A 3-month retrospective chart review was performed in an urban teaching hospital ED (> 70,000 visits/year). Women aged 12-45 years who had pelvic examinations and were released from the ED with a sole diagnosis of UTI were included. Patient complaints, physical findings, and laboratory results were reviewed. Laboratory evaluations included the complete blood count, urinalysis, urine pregnancy test, and cervical cultures for Neisseria gonorrhoeae, Chlamydia trachomatis, and Trichomonas. RESULTS: Of the 94 women who met study criteria, 53% had proven STDs (19% N. gonorrhoeae, 22% C. trachomatis, 33% Trichomonas). There was no difference between the patients with positive and negative tests for STDs with regard to complaints, physical findings, and laboratory results (all p > 0.05). CONCLUSIONS: Women undergoing pelvic examinations who are subsequently released from this urban ED with the diagnosis of UTI have a high (> 50%) prevalence of occult STDs. No complaint, physical finding, or laboratory result reviewed was associated with the risk of an STD. Consideration should be given to empirical antibiotic therapy in similar urban populations.

Adolescent↗

A method for testing denture adhesives.

An in vitro test is described that simulates the in vivo fate of a denture adhesive, namely destruction, dilution, and dissolution of the adhesive, by repeated measurement of tensile bond strength for the adhesive in isotonic saline over time. The bond strengths were measured under two different settings of the testing machine. The main compositions of three denture adhesive pastes, Fittydent, Fixodent, and Super Poli-Grip and one powder adhesive, Super Wernet's, were determined by infrared spectroscopy. The tensile bond strengths of these adhesives and those of pure tragacanth gum were subjected to a three-way analysis of variance. The Fittydent and Super Poli-Grip adhesives exhibited the best results over time. The most appropriate of the described methods for testing denture adhesives seem useful; however, when seen in relation to the results of a published clinical study where the patients were asked to evaluate the retention and the duration of some of these adhesives, there are indications that the clinical validity of the method might be improved if paste adhesives are tested at temperatures above 35 degrees C.

Adhesives↗

Mechanical properties of laser-welded cast and wrought titanium.

This study evaluated the mechanical properties of laser-welded cast and wrought titanium base and compared them with those of a brazed type IV casting gold alloy. Ultimate tensile strength, 0.2% yield strength, and percent elongation were recorded for joined and unjoined bars of the previously mentioned materials. Sections of titanium bars were laser-welded, and gold alloy bars were brazed. Both joining methods significantly reduced the ductility of the material. The strength of the cast gold alloy was superior to that of titanium. However, the strength of the laser-welded titanium equaled that of the brazed gold alloy, which suggests that dental restorations made of cast and wrought titanium would satisfy ordinary clinical requirements.

Analysis of Variance↗

In vitro properties of pressurized metered dose inhalers with and without spacer devices.

Pressurized metered dose inhalers (pMDIs) have been used for the administration of drugs to patients with asthma since the late 1950s. However, it is only during the last few years that attention has been paid to how they work in detail. Studies have shown that the first dose, after the inhaler has been at rest for some hours, can be very variable. For suspension formulations, shaking the inhaler before actuation is important, since omitting shaking will affect the dose uniformity. The addition of a spacer device may increase the variability of the available dose. Factors affecting the available dose are, the electrostatic charge on the walls of the spacer device, the volume of the spacer device and the choice of material for the spacer device. Moreover, the fine particle dose, a measure of the effective deposition of inhaled drug in the airways, has been shown to be greater with a pMDI and a spacer device in comparison with a pMDI alone and is dependent on the choice of impactor inlet.

Administration, Inhalation↗

A non-electrostatic spacer for aerosol delivery.

A pear shaped non-electrostatic spacer, composed of steel with a volume of 250 ml and equipped with a facemask containing integrated inlet and outlet valves for inspiration and expiration, was compared with three plastic spacers. The plastic spacers were primed with repeated puffs from a budesonide pressurised metered dose inhaler (p-MDI) to minimise the electrostatic charge on the plastic. The procedure prolonged the half life (t1/2) of the aerosol in the Nebuhaler from nine to 32 seconds. A normal cleaning procedure reduced the aerosol t1/2 back to baseline. The t1/2 of the aerosol in the metal spacer was 27 seconds and independent of the use of p-MDI. In vitro the maximum dose of budesonide from a p-MDI, expressed as a percentage of the nominal dose, was 56% from the non-electrostatic spacer, 61% from the Nebuhaler, 45% from the Babyhaler, and 30% from the AeroChamber. In 124 children, age 6 months to 6 years, suspected to have asthma the non-electrostatic spacer delivered a mean total dose of budesonide aerosol of 39% of the nominal dose, which was significantly higher than the Babyhaler (28%), the Nebuhaler (21%), and the AeroChamber (19%). These differences were most pronounced in children younger than 4 years. The improved dose delivery from the small volume non-electrostatic spacer is probably related to the non-electrostatic spacer material and the valves which assured unidirectional airflow from the spacer without adding any dead space in the inspiratory channel. The non-electro-static spacer should improve the cost effectiveness of aerosol treatment and, as the counteracting effects of proming and recharging of the plastic from cleaning are avoided, should deliver a more reliable dose.

Aerosols↗

Patients with rheumatoid arthritis benefit from early 2nd line therapy: 5 year followup of a prospective double blind placebo controlled study.

OBJECTIVE: To compare 2 treatment strategies in a prospective 5 year study of patients with rheumatoid arthritis (RA): early treatment with slow acting antirheumatic drugs (SAARD) versus a "wait and see" attitude. METHODS: One hundred thirty-seven patients with RA of < 2 years' duration entered a double blind placebo controlled study: patients in the "early" (E) group were treated with auranofin within one year of diagnosis of RA, and SAARD treatment in the initially placebo treated group was delayed 8 months compared with the former group. [The results after 2 years clearly favored early treatment (Borg G, Allander E, Lund B, et al: J Rheumatol 1988; 15:1747-54)]. RESULTS: After a total observation period of 5 years in 75 representative patients, continued improvement in the E group was demonstrated, and differences between the 2 groups were maintained with regard to clinical variables, outcome measures, and radiographic evaluation. CONCLUSION: The results indicate the existence of a therapeutic window in RA within the first 2 years of the disease.

Adult↗

Manual therapy with steroid injections--a new approach to treatment of low back pain. A controlled multicenter trial with an evaluation by orthopedic surgeons.

Fifty-three acute or subacute patients with low back pain were given standardized but optimized activating conventional treatment by primary health care teams. Forty-eight patients received an experimental treatment that included specific manual treatment, such as manipulation and specific mobilization, muscle stretching, auto-traction, and cortisone injections. After 4 months, the experimental group had a less restricted range of movement in extension, less restricted side-bending to the right and to the left, less local pain caused by extension and side-bending to the right, less pain radiating to the right leg caused by side-bending to the left, and a less positive straight leg raising test (both sides) than the conventionally treated group. Manual treatment was superior to the conventional activating treatment in normalizing pathologic findings on physical examination of the lower back. These results agree with the positive influence on pain, drug consumption, sick-leave, disability rating, and quality of life reported in other reports from the same study.

Adult↗

Proteoglycan metabolism in normal and inflammatory human macrophages.

To study proteoglycan metabolism in inflammatory macrophages, primary cultures of human macrophages were cultured in the absence and presence of bacterial lipopolysaccharide (LPS). When exposed to [35S]sulfate, the cells incorporated the label almost exclusively into chondroitin sulfate proteoglycan (CSPG), which was recovered from the culture medium and the cell layer. Cells stimulated with LPS secreted approximately three times more [35]CSPG into the culture medium than control cells. Furthermore, cell adhesion was also found to promote proteoglycan secretion; when nonadherent monocytic cells were induced to adhere, the release of proteoglycan increased two times. The increased secretion seen in LPS-stimulated macrophages was partly due to increased biosynthesis, but was mostly due to increased sorting of CSPG to the secretory pathway. Only about 20% of the CSPG synthesized in unstimulated cells was secreted, whereas the corresponding figure in LPS-treated cells was 35%. In both cell types, the remaining [35S]CSPG was degraded, probably in the lysosomes. The degradation was a two-step process. First, the [35S]CSPG was rapidly cleaved to yield free glycosaminoglycan (GAG) chains (t1/2 = 15 to 30 minutes). Secondly, the GAG chains were completely depolymerized (t1/2 = 2 to 3 hours). Neither resting nor LPS-stimulated cells sorted CSPG to intracellular storage, as is evident in many hematopoietic cells. The LPS-treated cells synthesized [35S]CSPG of smaller molecular size than did control cells, with GAG chains of approximate molecular mass of 12 kD versus 16 kD in control cells. No difference was seen in the disaccharide composition of the GAG chains; both LPS-stimulated and unstimulated cells expressed a mixture of 80% to 90% chondroitin 4-sulfate and 10% to 20% chondroitin 4,6-disulfate. N-terminal sequence and Northern blot analysis indicate that the core protein of the CSPG secreted by human macrophages is serglycin.

Amino Acid Sequence↗