OBJECTIVE: This explorative study aims at investigating how 'healthy' women describe and reason about participation in a cervical cancer screening programme in Sweden. The study is part of a multidisciplinary research project studying a population-based cervical cancer-screening programme from the perspective of different actors. SETTING AND METHODS: Data collection took place at three ante-natal health centres (ANHCs) in demographically diverse areas in the Stockholm region in spring 1995. Interviews were conducted and audiotaped with 66 'healthy' women at the ANHCs immediately before taking a Papanicolau test. Open questions such as 'Why have you come here today?' and 'What kind of test will you take?' were used to initiate the interview. Verbatim transcripts were analysed with a modified phenomenographical method to identify and describe qualitatively different ways of understanding cervical cancer screening. RESULTS: Four different ways of reasoning about cervical cancer screening are described, with only one similar to the biomedical rationale for screening with focus on attending for the test/results. Two types of reasoning refer to the invitation letter as a catalyst, with one emphasizing benefits in attendance and the second emphasizing hinders to attendance. A final way of reasoning focuses on the individual's own proactive role in prevention. Common themes are also identified. IMPLICATIONS: This study complements the research literature by providing a better knowledge base of the variations in reasoning among women attending screening, often seen as a homogenous group. It can contribute to better adapting the screening situation to the varied needs and expectations of the women who attend.

Adult↗

PubMedDate not supplied

Surgery for sporadic primary hyperparathyroidism in the elderly.

Retrospective analysis has been performed on 108 consecutive patients operated for primary hyperparathyroidism (HPT) at 75 to 85 years of age (mean 79 years). The preoperative serum calcium value averaged 2.99 mM, and six patients had hypercalcemic crisis. Psychic disturbances were seen in 60 patients (56%), 40% of whom demonstrated dementia. Skeletal and muscular complaints were registered in 29% and 19%, respectively, and only 6% were overtly asymptomatic. Cardiovascular diseases were presented by 69% of the patients, 13% had diabetes mellitus, and 26% were institutionalized prior to surgery. Bilateral neck exploration disclosed a single adenoma in 69%, which was of the oxyphil cell type in 13%, and water-clear (n = 3) or chief cell hyperplasia in 27%. The total glandular weight averaged 1085 mg. Altogether 72 patients operated on after 1980 demonstrated a perioperative (30-day) mortality of 1.4%; the corresponding morbidity of 8.7% mainly included infections as well as a vocal cord paralysis in one patient and two incisional hematomas. Analysis for mean 3.1 years postoperatively displayed reversal of hypercalcemia in 95% of the patients; 2.8% of those operated after 1980 had persistent disease. Symptoms seemed to be alleviated in 62%, with a similar rate attained in patients with dementia. Altogether 60 patients died from mainly cardiovascular diseases mean 4.2 years after the operation. Those succumbing the first postoperative year (n = 21) showed overrepresentation of cardiac diseases and diabetes mellitus. The results demonstrate prevalent psychic disturbances, oxyphil adenomas, and multiglandular parathyroid disease in elderly patients with primary HPT and favor rather liberal application of parathyroid surgery among these individuals.

Aged↗

PubMedDate not supplied

Ki-67 as a marker for cell cycle regulation by interferon.

The effects of interferon (IFN) on the expression of the nuclear antigen Ki-67 were studied in the two IFN-sensitive tumour cell lines Daudi and 251 MG, known to be arrested in the cell cycle in separate stages. The GO/G1-arrested Burkitt's lymphoma cell line Daudi displayed an increasing fraction of Ki-67 negative cells with time, concomitant with an increasing proportion of growth arrested cells. A small fraction of Ki-67 positive cells were found mainly arrested in G2/M. In contrast, no effect on Ki-67 expression was seen in IFN-resistant Namalwa cells, nor in the sensitive glioma cell line 251 MG, which is blocked in the S phase of the cell cycle. Agents blocking the cells in other phases of the cycle did not affect Ki-67 expression. However, after serum deprivation, no Ki-67 expression was found in the glioma cell line, while restimulation initiated expression after 12 hours as cells entered the S phase. We conclude that the Ki-67 antigen was not down regulated in all cells inhibited by IFN and thus does not seem to be useful to monitor clinical effects of IFN treatment.

Biomarkers, Tumor↗

PubMedDate not supplied

Effects of estramustine and its constituents on human malignant glioma cells.

Estramustine, a conjugate of estradiol-17 beta and nor-nitrogen mustard currently used in prostatic cancer, was found to exert a dose-dependent antiproliferative effect on the human malignant glioma cell lines U-251 MG and U-105 MG. At equimolar concentrations the inhibitory effects of the estramustine complex were clearly more pronounced than those of estradiol and nor-nitrogen mustard given alone or in combination. Flow cytometric analyses support the concept that estramustine cytotoxicity is mediated via separate mechanisms. The intact estramustine complex may be important for effects related to microtubule function which add to the cytotoxic potential of the alkylating component.

Cell Cycle↗

PubMedDate not supplied

Uncoupling of c-myc mRNA expression from G1 events in human T lymphocytes.

Normal human T-cells were grown in interleukin 2 (IL-2) until they became quiescent. Treatment with the phorbol-ester Phorbol-12, 13-dibutyrate (PBt2) made the cells competent to respond to IL-2 by expression of high affinity IL-2 receptors. These cells could be considered as G1 cells as they also displayed increased uridine incorporation, but they did not proceed into the S phase. c-myc mRNA expression was induced both by the phorbol ester and by IL-2, provided that receptors were present. A pulse with PBt2 increased c-myc mRNA transiently, while responsiveness to IL-2 and IL-2 receptors was maintained long after c-myc expression had subsided. IL-2 induced and maintained c-myc mRNA levels for more than 10h. Thus c-myc mRNA was expressed both when the cells were made competent to respond to the growth factor and when the cells progressed towards and through the S phase. In T lymphocytes c-myc mRNA expression was thus regulated in a complex way and was not necessary for maintaining G1 functions.

Gene Expression Regulation↗

PubMedDate not supplied

Interferon-induced inhibition of a malignant glioma cell line. Possible role of the 2' - 5' oligo (A) system.

The role of the IFN-induced enzyme 2' - 5' oligo (A) synthetase in the regulation of cell growth was analyzed by transfecting its reaction product into cells in the G1 and S phases of the cell cycle. Using the calcium phosphate transfection method, we found that the oligonucleotide was very stable compared to the levels reported to be induced by IFN. Under these circumstances, exponentially growing cells were blocked in the S phase as expected from previous results from studies on IFN treatment. In contrast, cells synchronized by serum starvation and readdition of serum were blocked in the cell cycle phase, where they resided when transfected. Precipitated oligonucleotide had drastic effects with degradation of rRNA and c-myc mRNA, in contrast to IFN-treated cultures where such effects were not detectable. 2' - 5' oligo (A) synthetase activity started to increase 6 hours after restimulation of quiescent cells with IFN and serum. We propose that several molecular targets may exist for the 2' - 5' oligo (A) system, and that the kinetics of expression of the oligonucleotide after addition of IFN determine the type of cell cycle block obtained in different tumor cells in vivo.

2',5'-Oligoadenylate Synthetase↗