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Biomedical subjects

G Norkrans

Publications and source records attributed to G Norkrans.

At least 109 records · Page 6Linked to original sources
PubMed1990

Epidemiology of hepatitis B virus (HBV) infections with particular regard to current routes of transmission and development of cirrhosis and malignancy.

The majority of hepatitis B virus (HBV) carriers world-wide becomes infected by transmission from asymptomatic carrier mother to infant, so-called "vertical" transmission, or early person to person so-called "horizontal" transmission, but sexual transmission is also important, especially in low endemicity areas. The histopathological findings at liver biopsies of these HBV-carriers vary from almost normal to severe chronic active hepatitis (CAH) with cirrhosis, and especially cirrhosis is associated with the development of HBV-related liver cancer. The reported annual incidence/100,000 of HBV-induced CAH in north-western Europe is 0.1-0.6 while the burden of the important chronic stages of hepatitis B is manyfold this in most developing countries.

Carcinoma, Hepatocellular↗
PubMed1989

Indole amine deficiency in blood and cerebrospinal fluid from patients with human immunodeficiency virus infection.

Twenty-four patients with human immunodeficiency virus (HIV) infection were investigated for possible changes in certain indole amine constituents in blood and cerebrospinal fluid (CSF). Albumin in serum was determined and used as a rough nutritional marker. Six of the 24 patients had acquired immunodeficiency syndrome AIDS, four had other clinical symptoms of HIV infection, and 14 had no apparent symptoms. The HIV-seropositive patients had significantly decreased tryptophan values; their blood concentrations were 28% lower and their CSF concentrations 30% lower than corresponding values in 14 healthy controls. The blood concentrations of 5-hydroxytryptamine (5-HT) were 50% lower, and the platelet content of 5-HT was 36% lower in HIV-infected individuals than in the control group. The most pronounced changes were invariably seen in the six cases with AIDS and in patients with a low number of CD4+ cells. No significant difference between controls and HIV-seropositive patients was detected in the mean CSF concentrations of 5-hydroxyindoleacetic acid (5-HIAA), although these levels were markedly reduced in four of the HIV patients. Neither was any significant difference seen between patients and controls in the serum concentrations of albumin.

Acquired Immunodeficiency Syndrome↗
PubMed1989

HIV-1-specific antibodies in cerebrospinal fluid mediate cellular cytotoxicity and neutralization.

Antibodies mediating HIV-1-specific cellular cytotoxicity (ADCC) and virus neutralizing activity were detected in the cerebrospinal fluid (CSF) and, as previously reported, in sera of subjects with varying severity of HIV-1 infection, including patients with or without neurologic or psychiatric symptoms. ADCC-mediating antibodies against target cells infected with the HTLV-IIIB strain of HIV-1 were less frequently present in CSF than in sera, 32 and 60%, respectively. The frequency of ADCC-positive CSF was comparable for the different clinical stages of the disease and was apparently not influenced by the presence or absence of neurologic/psychiatric symptoms. Virus-neutralizing activity was tested against HTLV-IIIB and one CSF-derived viral isolate. Serum antibodies neutralized HTLV-IIIB more frequently than the CSF isolate, 53 and 35%, respectively. In contrast, only three (7%) of the CSF specimens contained neutralizing activity to the CSF-derived isolate and none to HTLV-IIIB. Despite an intact blood-brain barrier in many subjects, the serum/CSF ratios of ADCC or neutralizing antibodies were lower than normally expected. This indicates that both ADCC-mediating and virus neutralizing antibodies may be intrathecally synthesized. Whether these antibodies are protective against or contribute to the histopathologic changes in the brain is not known at present.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Neopterin concentrations in cerebrospinal fluid and serum of individuals infected with HIV-1.

Neopterin, a biochemical marker for the activation of cell-mediated immune reactions, was determined in serum and cerebrospinal fluid (CSF) from patients infected with HIV-1. A significant correlation was found between serum and CSF neopterin concentrations, although concentrations of neopterin in serum were more closely correlated with the clinical severity of HIV-1 infection than those in CSF. However, higher CSF levels were observed in patients with neurologic/psychiatric symptoms than in unaffected patients. Also, quotients of CSF neopterin versus serum neopterin concentrations were increased, indicating intrathecal production of neopterin. Positive HIV-1 isolation from peripheral blood mononuclear cells (PBMC) was associated with higher neopterin concentrations in serum, when compared with negative HIV-1 isolation. Neopterin in CSF appears to be a suitable biochemical marker in patients with HIV-1 infection for detecting overt neurologic/psychiatric disturbances. The data suggest that in HIV-1 infected patients, cell-mediated immune reactions might be activated intrathecally and might contribute to neuropsychiatric disease.

Acquired Immunodeficiency Syndrome↗
PubMed1989

A randomized controlled open study of interferon alpha-2b treatment of chronic non-A, non-B posttransfusion hepatitis: no correlation of outcome to presence of hepatitis C virus antibodies.

33 patients with biopsy-proven chronic non-A, non-B posttransfusion hepatitis (NANB PTH) were randomized 2:1 to treatment with interferon alpha-2b (Introna) or to controls. The treatment group received 3 MU interferon 3 times weekly subcutaneously for 36 weeks. 22/33 (67%) patients were reactive for antibodies against hepatitis C virus (anti-HCV). 11/19 (58%) treated patients versus none of the 12 controls had a complete response with normalization of serum alanine aminotransferase levels (p less than 0.001). Another 4/29 (21%) treated patients had a partial response which was also seen in 4/12 (33%) controls; 4 treated patients were nonresponders, all with chronic active hepatitis. Nonresponders had a significantly higher mean weight than responders (p less than 0.05) and tended to have a longer duration of their disease before therapy. During the 6-month follow-up period post treatment 4/11 (36%) complete responders had a sustained response and 7/11 (64%) relapsed. All who were retreated responded again. We conclude that a majority of patients with chronic NANB PTH will respond to 9 months interferon alpha-2b treatment, but that only 1 out of 3 will have a sustained response 6 months post treatment, and that the reactivity for anti-HCV was not correlated to the outcome of therapy.

Adult↗
PubMed1989

Chronic non-A, non-B hepatitis in pregnancy: outcome and possible transmission to the offspring.

11 women with chronic non-A, non-B hepatitis (NANBH) were studied during 14 pregnancies. All women remained well, without signs of deterioration of liver function. On the contrary, serum transaminase levels were significantly lower in the latter part of the pregnancy compared to before and after. 12 children were born at full term. One child was born preterm and 1 child was stillborn after 36 gestational weeks. During follow-up, 8 of the children had elevated alanine amino transferase (ALT) levels in serum at least at one sampling occasion. Four children had ALT elevation in consecutive blood samples, 2 of whom had a longlasting ALT elevation, probably due to mother-to-infant transmission of NANBH virus(es).

Alanine Transaminase↗
PubMed1989

Interferon alpha-2b treatment of chronic posttransfusion non-A, non-B hepatitis: interim results of a randomized controlled open study.

32 patients with biopsy-proven chronic non-A, non-B posttransfusion hepatitis and raised aminotransferase levels since more than 1 year were randomized 2:1 to treatment with interferon alpha-2b, Introna, or to controls. The interferon group received 3 MU interferon 3 times weekly subcutaneously. Interim results 12 weeks after randomization showed that 14/21 (67%) patients in the treatment group had normalized their serum alanine aminotransferase levels whereas none of 11 patients in the control group had (p less than 0.001). If interferon alpha-2b is only suppressive during ongoing therapy or curative will be shown later during continued follow-up.

Adult↗
PubMed1989

Prevalence of hepatitis B virus markers in a random sample of women from Göteborg, Sweden.

The prevalence of the hepatitis B markers HBsAg, anti-HBc and anti-HBs was studied in 540 women from a randomised sample of women representative of the total population of women in Göteborg, Sweden at the ages of 26, 38 and 50 years. The prevalence of hepatitis B markers was 5.9%. No significant differences were found between the women with hepatitis B markers and the total population concerning education, place of residence during childhood, history of admission to hospital, surgery or blood transfusion, abuse of drugs or alcohol, life-time number of sexual partners or liver function tests. Only 8 of 37 (22%) women with hepatitis B markers had a history of jaundice. We conclude that psychological factors had no strong influence on the prevalence of hepatitis B in Swedish women in general.

Adult↗
PubMed1988

Cytological and immunoglobulin findings in cerebrospinal fluid of symptomatic and asymptomatic human immunodeficiency virus (HIV) seropositive patients.

Immunostimulation in the central nervous system (CNS) measured as abnormal intrathecal immunoglobulin production or activated lymphocytes in the cerebrospinal fluid (CSF), was found in 22 of 25 HIV seropositive patients. All of 11 patients with symptomatic HIV infection and nine of 14 asymptomatic patients had an increased IgG index or a Tourtellotte's production number indicating CNS infection. The amount of intrathecal immunoglobulin was not correlated to the severity of disease since five of six AIDS patients had only slightly elevated values, while some patients without AIDS had a high intrathecal immunoglobulin production. Activated lymphocytes and plasma cells in CSF were frequently found in symptomatic HIV patients without AIDS as well as in asymptomatic HIV seropositive patients. Macrophages and activated monocytes were observed in CSF from AIDS patients. The results indicate that HIV has a high neurotropicity and is spread to CNS in all stages of the infection.

AIDS-Related Complex↗
PubMed1988

Human immunodeficiency virus infection of the brain. II. Detection of intrathecally synthesized antibodies by enzyme linked immunosorbent assay and imprint immunofixation.

Sera and CSF from 29 patients in early and late stages of HIV infection were analysed for intrathecal antibody production. Elevated CSF-IgG indices indicating intrathecal IgG synthesis were demonstrated in 9 patients while 4 of 18 patients tested had oligoclonal IgG bands in the CSF. Analysis of HIV-specific antibodies by enzyme-linked immunosorbent assay (whole antigen and site-directed ELISA) and calculation of "antibody indices" (CSF/serum antibody quotient divided by CSF/serum albumin quotient) indicated intrathecal HIV antibody synthesis in 19 patients. Analysis of serum and CSF antibodies by an imprint immunofixation (IIF) method showed intrathecal synthesis of predominantly polyclonal HIV-IgG antibodies in 11 of 13 patients examined. IIF analysis of antibodies to six other infectious agents showed no intrathecal antibody production except in one patient who had minor fractions of intrathecally synthesized IgG antibodies to varicella zoster virus. The present results demonstrate that an intrathecal HIV-specific antibody response may be present in both early and late stages of HIV infection, and indicates that HIV may reach the brain at an early stage of infection.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Human immunodeficiency virus infection of the brain. I. Virus isolation and detection of HIV specific antibodies in the cerebrospinal fluid of patients with varying clinical conditions.

Isolation of the human immunodeficiency virus (HIV) has been attempted from the cerebrospinal fluid (CSF) of 29 subjects with varying severity of HIV infection. Virus could be isolated from patients in all stages of disease including patients with primary HIV infection and asymptomatic carriers. In the early stages of infection free virus was infrequently present in the CSF but could be isolated from the cells present in CSF. This suggests that HIV may reach the brain at a very early stage of infection and that initially there is little production of virus from infected cells. In the late stages of HIV infection, associated with increasing severity of immunodeficiency, free virus could readily be isolated from the CSF. With one exception, all of these patients had neurological and/or psychiatric symptoms, as compared to only 2 (of 13) subjects in the early stages of infection. All patients with HIV-specific antibodies in serum had antibodies also in CSF. Examined by a radioimmunoprecipitation assay, CSF was more often found to contain antibodies to the precursor (p55) of viral core proteins than the corresponding serum of the patients. We propose that immune disturbances have an essential pathogenic role in the neurological/psychiatric symptoms associated with HIV infection, possibly through allowing increased viral expression in the central nervous system.

AIDS-Related Complex↗
PubMed1988

Isolation frequency of human immunodeficiency virus from cerebrospinal fluid and blood of patients with varying severity of HIV infection.

Isolation of the human immunodeficiency virus (HIV) has been attempted from the cerebrospinal fluid (CSF) of 63 subjects at different stages of HIV infection, including asymptomatic carriers and patients with or without neurologic or psychiatric complications. In addition blood was collected from 40 of these subjects for virus isolation. HIV could be isolated from the CSF at all clinical stages with an overall frequency of 40%. In contrast, the frequency of HIV isolation from the blood was lower (32%) at the early stages of infection than in patients with severe disease (77%). HIV isolation from the CSF was more frequently positive in patients with neurologic or psychiatric complications than in patients showing no such disturbances (48 and 32%, respectively).

Acquired Immunodeficiency Syndrome↗
PubMed1988

Persistent alanine aminotransferase elevation in healthy Swedish blood donors--mainly caused by obesity.

Five hundred consecutive healthy blood donors were tested for serum alanine aminotransferase (ALT) and 44 (8.8%) had increased levels. Donors with and without raised ALT were compared in several aspects but only weight (expressed as percentage of ideal body weight) and sex differed significantly (119.1 +/- 14.5 and 106.3 +/- 12.8%, respectively; p less than 0.001 and males 97.7 and 77.1%, respectively; p less than 0.01). The 44 donors with raised ALT were followed up and in 13 out of 15 donors with persistently raised ALT without obvious reason, a liver biopsy was performed. Ten donors had various degrees of liver steatosis, 2 had normal liver morphology and in 1 donor chronic hepatitis could not be ruled out. If ALT screening is introduced as a surrogate test for non-A, non-B hepatitis in Swedish blood donors, we suggest that a correction for overweight must be considered in order to minimize donor loss.

Adolescent↗
PubMed1988

The use of doxycycline in nervous system Borrelia burgdorferi infection.

Alternatives to high dose benzylpenicillin treatment are sought for in patients with mild Borrelia burgdorferi nervous system infection. Doxycycline 100 mg twice daily for 10-20 days was used in nine patients with radicular pains, vertigo or weakness in the legs caused by B. burgdorferi infection. The patients had suffered from neurologic symptoms for a median time of five months. In eight patients doxycycline was orally administered and in one intravenously. All nine patients had remission of radicular pain and vertigo during the treatment period. Two patients with weakness in the legs improved slowly in muscle strength over a three month period. The doxycycline concentration in the cerebrospinal fluid was 0.2-1.0 mg/l and in serum 1.9-7.1 mg/l after five days treatment. Doxycycline treatment was found successful in our patients with mild tick borne neuroborreliosis.

Adult↗
PubMed1987

Chronic non-A, non-B hepatitis. A long-term follow-up study in 49 patients.

Forty-nine patients with biopsy-verified chronic non-A, non-B hepatitis (NANBH) of both percutaneously transmitted and sporadic types were followed up for up to 20 years (mean, 62 months +/- 44 months). Drug addicts were not included. Twenty-four patients had chronic persistent hepatitis (CPH), and 25 had chronic active hepatitis (CAH) or cirrhosis on the basis of the first biopsy. Patients with CPH were significantly younger than patients with CAH (mean age, 31 and 51 years, respectively; p less than 0.001). Standard laboratory data (means) correlated with histology, but great variations made liver biopsy essential for the diagnosis. Twenty-one patients were rebiopsied, and 24% had more severe lesions. In total, 16 patients (33%) had signs of cirrhosis. The disease seemed to resolve in eight patients (16%), whereas two patients died of it. Some patients with CPH might progress to CAH, and the frequent finding of cirrhosis in CAH implies the possibility of hepatic failure and fatality in chronic NANBH.

Adolescent↗