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Biomedical subjects

G Carlsson

Publications and source records attributed to G Carlsson.

At least 37 records · Page 2Linked to original sources
PubMed1997

Memory for words and drawings in children with hemiplegic cerebral palsy.

A list-learning paradigm was used to study learning and memory of verbal and figurative material in children with right versus left-sided hemiplegic cerebral palsy. Thirty-one children with right (n = 18), or left (n = 13) congenital hemiplegia were compared with normal controls (n = 19). All children had normal intelligence (IQ > 80), and were attending standard schools. The inclusion criteria for the two hemiplegic groups were; no epilepsy, no hearing or visual impairments, and a mild to moderate hemiparesis. The aim of this study was to explore material-specific (words and drawings) differences in the acquisition, recall and serial position effects in children with an early unilateral brain lesion. The left-hemisphere impaired (i.e. right hemiplegia) group showed impaired acquisition for drawings, as compared with the normal controls. There was also a material-specific difference in the serial position effect for all three groups. Learning of words followed the primacy principle, whereas the learning of drawings followed the recency principle. There were no group-differences in delayed-recall (i.e. long-term memory) for either words or drawings. The results are discussed in terms of acquisition and retention of verbal and figurative materials in relation to lesion side and size.

Adolescent↗
PubMed1997

Pitfalls in epidemiological analysis.

Epidemiologists rely heavily on the relative risk in their analyses and presentations. As an index it is intelligible and intuitively appealing but can give an exaggerated impression of the strength of the association and is unreliable for comparisons. This can be shown by deriving relative risks from a normal correlation surface with an unimpressive level of correlation. Relative risks ought to be handled with caution; the underlying population risk and the relative size of exposed and reference categories should be reported. Efforts to control for additional variables, confounders, by some kind of multi-variate technique, another standard procedure, could easily give a false sense of security. From time to time it has been made clear in the literature that errors of measurement in the third variable or in the additional variables could lead to the appearance of false independent effects, but these warnings do not seem to have been heeded nearly as much as they deserve. A simulation experiment is used to bring the lesson home, with realistic numerical assumptions. A moderate degree of error contamination will produce spurious effects. This has nothing to do with sampling errors, large samples rather aggravate this danger. In meta-studies this is a source of error and conflicting results to take account of.

Confounding Factors, Epidemiologic↗
PubMed1997

Effects of intravesical instillation of 5-fluorouracil and interferon in patients with recurrent superficial urinary bladder carcinoma. A clinical and pharmacodynamic study.

Eleven patients with recurrent superficial bladder tumours were treated with 6 weekly instillations of 10 million IU Introna and 1000 mg 5-fluorouracil for 1 h. Before and immediately after the first treatment biopsies were taken from normal urothelium and tumour for analysis of thymidylate synthase (TS). One papillary tumour was left as a marker. Tumour tissue had 9 times higher TS concentrations than normal urothelium (0.97 versus 0.11 pmol/g, p < 0.005). Despite a large variation in TS concentration in the tumours between different patients (range 0.02-2.24 pmol/g), after instillation the TS concentration decreased significantly in all but one patient. Six patients had complete and 2 had partial tumour regression after treatment. The effect was inversely correlated to the initial TS value. A low TS value seemed to predict a good response. The data suggest that weekly administrations are not sufficient in those with high TS concentrations. New treatment schedules may be beneficial in those with highly proliferating bladder tumours.

Administration, Intravesical↗
PubMed1996

Children with benign focal sharp waves in the EEG--developmental disorders and epilepsy.

Focal sharp waves (shw) in the childhood EEG with predominantly centrotemporal localization are a diagnostic hallmark of idiopathic partial epilepsy and have been shown to be genetically determined. Absence of neurological and neuropsychological impairment was long considered to be a prerequisite for diagnosis. For years, this diagnostic paradigm obscured the large phenotypic variability of genetically determined focal shw. The purpose of the present review is to survey and critically evaluate the widely dispersed literature on this topic. Two main groups can be distinguished: Idiopathic partial epilepsies and specific developmental disorders such as dysphasia, dyslexia etc. These conditions, however, do not represent clear-cut nosologic entities, but exhibit large symptomatic overlaps. In non-epileptic children, developmental disabilities constitute the main symptoms, in epileptic children-at least in non-selected groups-they are an optional feature. Conversely, epileptic phenomena can dominate the clinical picture or be an optional symptom in developmentally disabled children. The wide spectrum of epileptic and non-epileptic disorders probably represents the multifarious clinical manifestations of a common widespread, genetically determined pathogenetic mechanism. The marked age-dependency of the EEG and clinical symptoms, and the almost regular disappearance of both at puberty appear to justify the hypothesis of a hereditary impairment of brain maturation. The large phenotypic variability can be explained by differences in location and extent of the maturational disturbance as well as by the effect of additional genetic and environmental factors. The nature and cause of the hypothetical maturational disturbance are still unknown.

Adolescent↗
PubMed1996

Incidence of neoplasms in ages 0-19 y in parts of Sweden with high 137Cs fallout after the Chernobyl accident.

The incidence of neoplasms in childhood and adolescence in northern and central Sweden before and after the radioactive fallout from the Chernobyl accident was investigated in an ecologic study, 1978 to 1992. The study included all parishes in the six most contaminated counties classified after aerial mapping of ground radiation from 137Cs and investigated 746 cases of neoplasms in ages 0-19 y, diagnosed in the six counties. Incidence and relative risks of neoplasms were compared in areas with high, intermediate, and low contamination after versus before the Chernobyl accident in 1986. A continuous increase of brain tumor incidence in the ages 0-19 y during the period 1978-92 without clear relationship to the Chernobyl fallout was discovered. No clear relationship between the incidence of brain tumor and the exposure to varying levels of radiation from 137Cs was apparent. A somewhat decreased relative risk of acute lymphatic leukemia appeared in areas with increased exposure. Other neoplasms showed no changes in incidence over time or with regard to exposure. Until now, there is no indication that the Chernobyl accident has affected the incidence of childhood and adolescence neoplasms in Sweden, but it is still too early for any final conclusion about the effect of this event.

Adolescent↗
PubMed1996

Autism and epilepsy (and tuberous sclerosis?) in two pre-adolescent boys: neuropsychiatric aspects before and after epilepsy surgery.

We report on two pre-adolescent boys with a combination of severe seizure disorders and severe-moderate autism who underwent brain surgery for their epilepsy at the ages of 9 and 10 years, respectively. Both boys became seizure-free and initially improved dramatically with regard to autism symptoms. One of the boys continued to improve, but the other had a relapse to his pre-operative state in conjunction with his pubertal growth spurt. Several years after surgery, one of the boys remained much improved with respect to his autism. The other subject showed some improvement with respect to self-injury and aggression, and had slightly lower scores on screens for autism symptoms than in the year preceding epilepsy surgery. The histopathological examination of the brain tissue that was removed at surgery suggested a diagnosis of tuberous sclerosis in both cases.

Autistic Disorder↗
PubMed1996

Relevance of norm values as part of the documentation of quality of life instruments for use in upper gastrointestinal disease.

This article presents the relevance of norm values to a battery of Quality of Life questionnaires for use in upper gastrointestinal disorders. The derivation of reference values offers an important contribution by confirming the ability of the questionnaires to differentiate patients from healthy controls. Two self-administered questionnaires, the Psychological General Well-being (PGWB) index and the Gastrointestinal Symptom Rating Scale (GSRS) were used. The norm values were derived in a randomly selected sample from a Swedish population consisting of 4624 individuals (reference group). The patients comprised more than 900 patients with gastroesophageal reflux disease (GORD) included in clinical trials. In the reference group, males reported significantly higher values on well-being as compared with women, whereas women reported more pronounced gastrointestinal symptoms than men. Generally, the younger persons and the group aged 60-70 years reported the highest well-being. Among gastrointestinal patients women scored lower and reported more symptoms than men. With increasing age, well-being improved and symptoms declined. Even though the well-being and symptoms scores differed between patient and the reference group similar patterns in terms of age and gender were observed. In summary, the results show that there are differences with respect to gender and age among normal controls as well as in GORD patients. These aspects have to be considered in clinical studies. The results also support the discriminative ability of the Quality of Life instruments.

Adult↗
PubMed1996

Different intravenous administration techniques for 5-fluorouracil. Pharmacokinetics and pharmacodynamic effects.

The pharmacokinetics after 20 min intravenous infusion or a 2 min bolus (push) injection of 5-fluorouracil (500 mg/m2) were studied in 14 colorectal cancer patients. Treatment effects and toxicity related to the administration technique of 5-fluorouracil were retrospectively analysed in 198 colorectal cancer patients. The AUC after bolus injection was 6158 +/- 874 micromol/l*min compared to 3355 +/- 428 micromol/l*min after short-time infusion of 5-fluorouracil (p < 0.01). The mean peak-level after bolus injection was 341 +/- 34 microM versus 161 +/- 17 microM after a short-time infusion (p < 0.01). Patients receiving bolus injections had significantly better treatment result (32% partial remission) than patients receiving infusion (10% partial remissions, p < 0.001). Toxic side-effects were more frequently encountered after bolus injection but subjective improvement was also more frequently experienced by these patients. Bolus 5-fluorouracil push injection rather than a short-time infusion appears to be the more efficient administration technique.

Aged↗
PubMed1996

Thymidylate synthase in advanced gastrointestinal and breast cancers.

Knowledge of population thymidylate synthase (TS) levels in malignant tumors and normal tissues is essential for the use of TS as a predictor for 5-fluorouracil treatment. Tumor tissue TS levels in fresh frozen surgical biopsies from 136 patients with gastrointestinal or breast cancer, not previously subjected to chemotherapy, were analysed by [3H]FdUMP radioligand binding assay. TS levels were 2.4 +/- 0.31 pmol/g in liver metastases of colorectal cancer (n = 87), 4.2 +/- 1.0 pmol/g in primary colorectal cancer (n = 13), 2.7 +/- 0.93 pmol/g in gastric cancer (n = 13), 3.1 +/- 1.7 pmol/g in pancreatic cancer (n = 10), 3.4 +/- 1.4 pmol/g in breast cancer (n = 13) and 0.58 +/- 0.075 pmol/g in normal liver parenchyma (n = 24). TS levels were significantly higher in malignant tumor tissues compared to normal liver parenchyma.

Antimetabolites, Antineoplastic↗
PubMed1995

Antitumour effects of pure diastereoisomers of 5-formyltetrahydrofolate in hepatic transplants of a rodent colon carcinoma model.

The effects of the two diastereoisomers of 5-formyltetrahydrofolate on tumour growth, thymidylate synthase (TS, EC 2.1.1.45) levels, and potentiation of 5-fluorouracil cytotoxicity were studied in an in vivo rat colon carcinoma model, transplanted to liver. The animals were randomized into eight groups, treated with daily i.v. tail vein injections of racemic (d,l)-5-formyltetrahydrofolate (5-CHO-FH4), 15 mg/kg, (1)-5-CHO-FH4 7.5 mg/kg, and (d)-5-CHO-FH4 7.5 mg/kg, 5-fluorouracil (FUra) 30 mg/kg, (d,l)-5-CHO-FH4 15 mg/kg+FUra 30 mg/kg, (l) 5-CHO-FH4 7.5 mg/kg+FUra 30 mg/kg, and (d)-5-CHO-FH4 7.5 mg/kg+FUra 30 mg/kg, and a sham-treated control group. The average tumour size of the groups was equal at the start of treatment. After six days' treatment the average tumour sizes were at laparotomy 3.3 +/- 1.0 g in the (d/l)-5-CHO-FH4 treated group, compared to 2.0 +/- 0.1 g in the FUra treated group and 7.1 +/- 3.1 g in the controls. Natural (l)-5-CHO-FH4 promoted tumour growth (average tumour weight 10.8 +/- 4.0 g), whereas the unnatural (d)-5-CHO-FH4 alone retarded it (average tumour weight 1.2 +/- 0.40 g). (l)-5-CHO-FH4 induced a significant increase in tumour tissue TS levels by [3H]FdUMP radioligand assay (27.5 +/- 8.4 pmol/g tumour tissue) compared to controls (16.8 +/- 6.1 pmol/g tumour tissue). Increases in 5,10-methylenetetrahydrofolate and tetrahydrofolate occurred with FUra alone, with a further statistically significant increase in both folates with the addition of (d)-5-CHO-FH4 to FUra.

Animals↗
PubMed1994

Dystonia and dyskinesia in glutaric aciduria type I: clinical heterogeneity and therapeutic considerations.

Glutaric aciduria type I (GA-I) is an inborn error in the degradation of lysine, hydroxylysine, and tryptophan due to a deficiency of glutaryl-CoA dehydrogenase. Glutaric, 3-OH-glutaric, and glutaconic acids are excreted in the urine, particularly during intercurrent illness. The enzyme may be assayed in leukocytes, cultured fibroblasts and chorionic villi. Twelve new cases, 9 months-16 years of age, are reported, comprising all known cases of GA-I in Sweden and Norway. Ten had a severe dystonic-dyskinetic disorder, one had a mild hyperkinetic disorder, and one was asymptomatic. Two children died in a state of hyperthermia. Carnitine deficiency and malnutrition developed in patients with severe dystonia and dysphagia, which necessitated substitution and gastrostomy. A slowly progressive dyskinetic disorder developed in spite of adequate early dietary treatment in one subject. Macrocephaly was found in three. Computed tomography and magnetic resonance investigations in 10 showed deep bitemporal spaces in 7. Neuropsychological testing of 8 of 12 subjects demonstrated receptive language function to be superior to expressive language and motor function. Cognitive functions were obviously less affected than motor functions. A review of 57 pooled cases showed that a severe dystonic syndrome developed in 77%, a mild extrapyramidal syndrome in 10%, and 12% were asymptomatic. This disorder may pass undetected in the cerebral palsy and mentally retarded child and adult populations. Repeated urine examinations of organic acids in the urine and enzyme assay may be necessary to confirm GA-I.

Adolescent↗
PubMed1994

Dichotic listening and focused attention in children with hemiplegic cerebral palsy.

Dichotic listening data are reported from children with left and right hemiplegia, compared with a normal, age-matched, control group. The dichotic listening test was performed under two different attentional instructions. The aim of the study was to investigate whether lateral injury to one hemisphere also affects the capacity to direct attention in a laterality task because of inattention. The dichotic task consisted of consonant-vowel syllables that were presented with two different instructions, to attend to the left- or right-ear stimulus. The results showed that the control children had a right-ear advantage during the forced-right attention instruction, and a small left-ear advantage during the forced-left instruction. The two hemiplegia groups, however, showed the same ear advantage irrespective of attentional instruction. The results are discussed in terms of hemi-inattention and hypoarousal of the lesioned hemisphere in children with hemiplegia.

Adolescent↗
PubMed1994

Verbal and non-verbal function of children with right- versus left-hemiplegic cerebral palsy of pre- and perinatal origin.

Eighteen children with right- and 13 with left-sided congenital hemiplegia were compared with 19 normal age-matched controls for verbal and non-verbal function. CT scans were obtained from 27 of the 31 hemiplegic children. The two hemiplegic groups were impaired in non-verbal function compared with controls. The right-hemiplegic group was more impaired in verbal function than the left-hemiplegic group and controls; however, impairments were restricted to the girls in the right-hemiplegic group. The results are discussed in terms of cerebral plasticity and functional reorganisation of cognitive functions after an early unilateral injury. It is argued that girls with left-hemisphere lesions may be more limited in cerebral plasticity than boys.

Adolescent↗