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Biomedical subjects

H Johansson

Publications and source records attributed to H Johansson.

At least 163 records · Page 9Linked to original sources
PubMed1991

Hodgkin's disease in northern Sweden 1971-1981. II. A retrospective analysis of prognostic factors.

Factors relevant for prognosis were retrospectively studied in a series of 133 morphologically reviewed patients with Hodgkin's disease collected between 1971 and 1981. For the whole material complete remission rate was 74% and 5-year survival was 62%. These seemingly rather poor results could be explained by a high mean age (48 years) in this relatively unselected material, in combination with a very unfavourable outcome for the elderly patients. In a multivariate analysis of prognostic factors age of the patient turned out to be the only independent factor with a significant bearing on the prognosis.

Adolescent↗
PubMed1991

Hodgkin's disease in northern Sweden 1971-1981. III. The clinical and prognostic impact of age.

A retrospective material of 133 patients with Hodgkin's disease treated between 1971 and 1981 was analysed. In part II of this study it was shown that the prognosis was closely associated with age of the patient. In this part some clinical factors, including therapy, were compared between 66 patients less than 50 years of age and 67 patients 50 years or more. The groups differed mainly in the outcome of primary chemotherapy. Older patients with Hodgkin's disease were particularly vulnerable to chemotherapy, probably as an effect of the disease itself.

Adolescent↗
PubMed1991

DNA ploidy pattern of parathyroid parenchymal cells in renal secondary hyperparathyroidism with relapse.

The nuclei of parathyroid parenchymal cells, analyzed using image cytometry (ICM), in relapsing and non-relapsing secondary hyperparathyroidism due to uremia, showed a DNA-distribution pattern of diploid type. Nevertheless, some differences were observed within the groups, as regards the concept of 'scattered cells' in ICM DNA histograms. The relative incidence of 'scattered cells' was particularly high in the histograms from parathyroid glands with nodular hyperplasia and in those from parathyroid parenchyma grafted into the skeletal musculature. In these two kinds of parathyroid specimens, the 'scattered cells' were both of chief-cell and oxyphil-cell types. In contrast, 'scattered cells' were not so conspicuous when parenchymal cells of glands with diffuse hyperplasia were analyzed. As there is some clinical and histopathological evidence that the cells in both nodular-hyperplastic and autografted parathyroid parenchyma have increased growth potential, it is hypothesized that the relative incidence of the 'scattered cells' in the ICM DNA histograms indicates an increased proliferative activity.

Adult↗
PubMed1991

Fusimotor reflex profiles of individual triceps surae primary muscle spindle afferents assessed with multi-afferent recording technique.

The experiments were performed on 21 cats anaesthetized with alpha-chloralose. The aim of the study was to investigate sets of simultaneously recorded spindle afferents (2-4 in each set) from the triceps surae muscle (GS) with respect to the pattern of fusimotor reflex effects evoked by different types of ipsi- and contralateral reflex stimulation. The afferents' responses to sinusoidal stretching of the GS muscle were determined and the fusimotor reflex effects were assessed by comparing the afferent responses (i.e. the mean rate of firing and the depth of modulation) elicited during reflex stimulation with those evoked in absence of any reflex stimulus. Natural of electrical activations of ipsi- and contralateral muscle, skin and joint receptor afferents were used as reflex stimuli. The spindle afferents were influenced by several modalities and from wide areas, with a majority responding to both ipsi- and contralateral stimuli. A particular reflex stimulus often caused different effects on different afferents, and the various reflex stimuli seldom gave similar effects on a particular afferent. Multivariate analysis revealed that the variation in response profiles among simultaneously recorded afferents were as great as between afferents recorded on different occasions. This suggests that the individualized response prifiles, observed in earlier investigations, represent a very diversified reflex control of the spindle primary afferents, and are not a reflection of changes in the setting of the spinal interneuronal network, occurring during the time interval between the recordings of different units. Also, there was no relation between the conduction velocity of the afferents and the reflex profiles of the afferents, but non-linear relations were found between effects elicited by different types of stimuli. Indications were also found that it may be possible to separate the population of GS muscle spindles into subgroups, according to the fusimotor effects exhibited by activation of various categories of ipsi- and contralateral receptor afferents. It is concluded that one possible way of making the very complex reflex system controlling the muscle spindles intelligible may be a combination of multiple simultaneous recordings of spindle afferents and multivariate analysis.

Afferent Pathways↗
PubMed1991

Fusimotor reflexes influencing secondary muscle spindle afferents from flexor and extensor muscles in the hind limb of the cat.

The purpose of this study was to investigate secondary muscle spindle afferents from the triceps-plantaris (GS) and posterior biceps and semitendinosus (PBSt) muscles with respect to their fusimotor reflex control from different types of peripheral nerves and receptors. The activity of single secondary muscle spindle afferents was recorded from dissected and cut dorsal root filaments in alpha-chloralose anaesthetized cats. Both single spindle afferents and sets of simultaneously recorded units (2-3) were investigated. The modulation and mean rate of firing of the afferent response to sinusoidal stretching of the GS and PBSts muscle were determined. Control measurements were performed in the absence of any reflex stimulation, while test measurements were made during reflex stimulation. The reflex stimuli consisted of manually performed movements of the contralateral hind limb, muscle stretches, ligament tractions and electrical stimulations of cutaneous afferents. Altogether 21 secondary spindle afferents were investigated and 20 different reflex stimuli were employed. The general responsiveness (i.e. number of significant reflex effects/number of control-test series) was 52.4%, but a considerable variation between different stimuli was found, with the highest (89.9%) for contralateral whole limb extension and the lowest (25.0%) for stretch of the contralateral GS muscle. The size of the response to a given stimulus varied considerably between different afferents, and, in the same afferent, different reflex stimuli produced effects of varying size. Most responses were characterized by an increase in mean rate of discharge combined with a decrease in modulation, indicative of static fusimotor drive (Cussons et al., 1977). Since the secondary muscle spindle afferents are part of a positive feedback loop, projecting back to both static and dynamic fusimotor neurones (Appelberg Et al., 1892 a, 1983 b; Appelberg et al., 1986), it is suggested that the activity in the loop may work like an amplified which, during some circumstances, enhance the effect of other reflex inputs to the system (Johansson et al., 1991 b).

Afferent Pathways↗
PubMed1991

Receptors in the knee joint ligaments and their role in the biomechanics of the joint.

The knee joint ligaments contain Ruffini, Pacinian, Golgi, and free-nerve endings with different capabilities of providing the CNS with information about movement and position as well as about noxious events. Skeletomotor neurons (alpha-motoneurons) are known to be influenced only very rarely and weakly from low-threshold mechanoreceptors in the ligaments, while the effects on the tau-muscle-spindle system in the muscles around the knee are so potent that even ligament stretches at very low loads may induce major changes in the responses of the muscle spindle afferents. Since the primary muscle spindle afferents participate in the regulation of muscular stiffness, the receptors in the knee joint ligaments probably contribute, via the tau-muscle-spindle system, to preparatory adjustment (pre-setting) of the stiffness of the muscles around the knee joint, and thereby to the joint stiffness and the functional joint stability.

Afferent Pathways↗
PubMed1991

A sensory role for the cruciate ligaments.

Morphologic, physiologic, and clinical evidence for the sensory role of the cruciate ligaments is reviewed. The cruciate ligaments accommodate morphologically different sensory nerve endings (Ruffini endings, Pacinian corpuscles, Golgi tendon organlike endings, and free nerve endings) with different capabilities of providing the central nervous system with information not only about noxious and chemical events but also about characteristics of movements and position-related stretches of these ligaments. A survey of available data reveals that low threshold joint-ligament receptor (i.e., mechanoreceptor) afferents evoke only weak and rare effects in skeletomotor neurons (alpha-motor neurons), while they frequently and powerfully influence fusimotor neurons (gamma-motor neurons). The effects on the gamma-muscle-spindle system in the muscles around the knee are so potent that even stretches of the cruciate ligaments at relatively moderate loads (not noxious) may induce major changes in responses of the muscle spindle afferents. As the activity in the primary muscle spindle afferents modifies the stiffness in the muscles, the cruciate ligament receptors, via the gamma-muscle-spindle system, may participate in the regulation and preprogramming of the muscular stiffness around the knee joint and thereby of the knee joint stiffness. Thus, the sensory system of the cruciate ligaments is able to significantly contribute to the functional stability of the knee joint.

Anterior Cruciate Ligament↗
PubMed1990

Randomized trial of adjuvant tamoxifen combined with postoperative radiation therapy or adjuvant chemotherapy in postmenopausal breast cancer.

From 1976 to 1984, 427 postmenopausal women with high-risk breast cancer (pN + or pT greater than 30 mm) were randomized between postoperative radiation therapy (RT), radiation therapy plus tamoxifen (RT-TAM), adjuvant chemotherapy (CT), or chemotherapy plus tamoxifen (CT-TAM). Surgery was a modified radical mastectomy in all cases. The radiation therapy was given with high-voltage techniques and included the chest wall and regional nodes. The dose was 4600 cGy/4 1/2 weeks. Tamoxifen was given at a dose of 40 mg daily for 2 years. The adjuvant chemotherapy consisted of 12 cycles of cyclophosphamide, methotrexate, and 5-fluorouracil (CMF) (or chlorambucil, methotrexate, and 5-fluorouracil [LMF] for patients entered before 1978). At a median follow-up time of 6 1/2 years the recurrence-free survival was significantly better for patients allocated to radiation therapy compared to chemotherapy and for patients allocated to tamoxifen compared to no adjuvant endocrine treatment (P less than 0.01). At 10 years the recurrence-free survival for patients in the RT-TAM, RT, CT-TAM, and CT groups was 63%, 57%, 47%, and 31%, respectively. A significant reduction of treatment failures with tamoxifen was only observed among patients with estrogen receptor-positive tumors. The overall survival difference in favor of patients allocated to radiation therapy or tamoxifen was not significant: the respective survival percentage at 10 years in the RT-TAM, RT, CT-TAM, and CT group was 65%, 62%, 52%, and 50%. The results indicate that postoperative radiation therapy continues to play an important role in the primary management of postmenopausal women with high-risk breast cancer and that the addition of tamoxifen may further improve the results among ER-positive patients.

Aged↗
PubMed1990

500-Kilodalton calcium sensor regulating cytoplasmic Ca2+ in cytotrophoblast cells of human placenta.

Two monoclonal IgG antibodies E11 and G11, which react with parathyroid and kidney tubule cells, are in the present communication demonstrated to immunostain the surface of cytotrophoblast cells in human placenta. The G11 but not the E11 antibody has earlier been found to interfere with the sensing and gating of extracellular calcium in parathyroid cells. Microfluorometric measurement of the cytoplasmic calcium (Ca2+i) concentration was performed on suspended placental cells loaded with fura-2. The E11-positive placental cells displayed biphasic and parathyroid-like increases in Ca2+i in response to extracellular Ca2+. This increase was blocked by the G11 antibody and absent in the E11-negative placental cells. A sandwich enzyme-linked immunosorbent assay was constructed in which the G11 and E11 antibodies were shown to react with the same molecule. This calcium sensor was isolated and found to consist of a single, glycosylated polypeptide of approximately 500 kDa.

Antibodies, Monoclonal↗
PubMed1990

Activity in receptor afferents from the anterior cruciate ligament evokes reflex effects on fusimotor neurones.

Responses from 2-4 muscle spindle afferents from triceps surae and/or posterior biceps and semitendinosus muscles were simultaneously recorded in cats anaesthetized with alpha-chloralose. It was demonstrated that stretch of the anterior cruciate ligament (ACL) of the ipsilateral knee causes changes in dynamic and/or static sensitivity of primary and secondary spindle afferents to sinusoidal stretching. The changes were due to reflex actions of stretch/tension-sensitive receptor afferents from ACL on dynamic and static fusimotor neurones. The findings support the hypothesis that ACL-afferents contribute to the regulation of muscular stiffness around the knee, and thereby also to dynamic knee joint stability.

Animals↗
PubMed1990

Mortality by laterality of the primary tumour among 55,000 breast cancer patients from the Swedish Cancer Registry.

To examine the hypothesis that radiotherapy for breast cancer can cause myocardial infarction, cause-specific mortality by laterality of the primary tumour was analysed among 54,617 breast cancer patients reported to the Swedish Cancer Registry during 1970-1985. The rationale was that radiotherapy for a left-sided breast cancer invariably results in higher doses of radiation to the myocardium than a similar treatment given for a right-sided tumour whereas other possible risk factors for cardiovascular disease probably are unrelated to the laterality of the tumour. The median follow-up was 9 years (range 1-17 years). Patients with left-sided tumours were found to have a higher mortality due to myocardial infarction than patients with right-sided tumours (P less than 0.01) but there was no difference in regard to total intercurrent mortality. Further analyses of individual radiotherapy studies are warranted to quantify the excess risk associated with radiation and to study the significance of the type of radiation, portal arrangements, total dose and fractionation. It seems reasonable to assume that adverse effects of radiation are dose-related and may thus be minimised or prevented by the use of appropriate treatment techniques.

Breast Neoplasms↗
PubMed1990

Uteroplacental blood flow measured by placental scintigraphy during epidural anaesthesia for caesarean section.

The uteroplacental blood flow was measured before and during epidural anaesthesia for caesarean section in 11 women. The blood flow was measured with dynamic placental scintigraphy. After an i.v. injection of indium-113m chloride, the gamma radiation over the placenta was recorded with a computer-linked scintillation camera. The uteroplacental blood flow could be calculated from the isotope accumulation curve. The anaesthesia was performed with bupivacaine plain 0.5%, 18-22 ml and a preload of a balanced electrolyte solution 10 ml/kg b.w. was given. The placental blood flow decreased in eight patients and increased in three with a median change of -21%, not being statistically significant. No correlation between maternal blood pressure and placental blood flow was found.

Adult↗
PubMed1990

Incidence of sporadic and familial medullary thyroid carcinoma in Sweden 1959 through 1981. A nationwide study in 126 patients. Swedish MCT Study Group.

Medullary thyroid carcinoma (MTC) was identified in 276 patients (in 27 diagnosed at autopsy) by a review of virtually all 6,513 notifications of primary thyroid cancer ot the National Cancer Registry in Sweden 1959 through 1981. The diagnosis was confirmed in 268 of the 276 cases by histopathological and histochemical reexamination. Anamnestic data and morphological characteristics indicated that 208 (75%) patients had sporadic and 68 (25%) familial MTC. The mean ages at diagnosis of these two groups were 57.0 and 42.6 years respectively. The age-standardized incidence rate per 10(5) inhabitants was 0.18 for males and 0.23 for females. The age-specific incidence of sporadic MTC increased markedly with age, whereas no unequivocal rise was found after the age of 20 for familial disease. Standardized morbidity ratios (SMR), calculated separately for each of the six Swedish health care regions, revealed a roughly two-fold and mostly non-significant geographical variation in the occurrence of sporadic MTC. SMR for familial disease varied, however, between 0 and 306 and deviated highly significantly from the national average in four of the six regions. Regional differences in diagnostic intensity were considered unlikely as the sole explanation of this finding.

Adult↗
PubMed1990

Clinical and experimental advances in sporadic primary hyperparathyroidism.

Primary hyperparathyroidism (HPT) has shown prevalence of up to 3% among elderly women in Nordic health screening surveys, and is increasingly diagnosed in patients with diffuse neuromuscular or psychiatric symptoms. Primary HPT, even with mild hypercalcemia, is associated with increased mortality risk, mainly from cardiovascular disease. Despite the efficacy of new methods, reliable histopathologic distinction between adenomatous and hyperplastic parathyroid disease may still be difficult, and indeed circumstantial evidence suggests that adenoma and chief cell hyperplasia are not always distinctly separate pathophysiologic entities. Irrespective of symptoms, the hyperplasia is associated mainly with mild to moderate hypercalcemia, and may thus constitute an early form of HPT. A more liberal attitude to surgery in primary HPT would increasingly extend treatment to less clear-cut cases. The demonstration by monoclonal antiparathyroid antibodies of a specialized calcium receptor mechanism on the surface of parathyroid cells and its reduced expression in pathologic parathyroid tissue seems to explain defective parathyroid cell function and ensuing hypercalcemia in HPT. These antibodies appear to offer new prospects in parathyroid histopathology and research.

Antibodies, Monoclonal↗