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Biomedical subjects

H Jonsson

Publications and source records attributed to H Jonsson.

At least 19 recordsLinked to original sources
PubMed1997

Anticipating retirement: the formation of narratives concerning an occupational transition.

OBJECTIVE: This study is the first part of a longitudinal investigation of the retirement process. This stage of the inquiry concerned how older persons anticipate their retirement. METHOD: Thirty-two workers were randomly selected from all workers age 63 years in a suburb of Stockholm. They participated in semistructured interviews about their work and their expectations for retirement. RESULTS: The participants narratives illustrated the complex work of interpreting the past and expected meaning in one's occupational life. The narratives, which anticipated widely different future trajectories, revealed many of the challenges and dilemmas of anticipating retirement and the close association of work experience to expectations for retirement. In particular, the narratives highlighted the participants' concerns about maintaining the quality of experience in activity. The findings also demonstrate the process by which persons anticipate and make choices about life change. CONCLUSIONS: People anticipate retirement through volitional narratives in which they link together past, present, and future. Understanding this volitional process of interpreting, anticipating, and making choices is important to understanding how people adapt to life changes.

Adaptation, Psychological↗
PubMed1997

IgA rheumatoid factor correlates with changes in B and T lymphocyte subsets and disease manifestations in rheumatoid arthritis.

OBJECTIVE: To analyze the relationship between lymphocyte subsets, different rheumatoid factor (RF) isotypes, and clinical features in patients with rheumatoid arthritis (RA). METHODS: Patients with established RA (n = 95) were examined clinically and blood samples were collected for measurements of RF by ELISA and for analysis of lymphocyte subsets by flow cytometry. RESULTS: IgA RF positive patients had more severe disease and higher prevalence of extraarticular manifestations than the other patients. Patients with elevated IgA RF had a higher percentage of CD5+ B cells and of CD4+CD45RO+ T cells compared to the other patients with RA or controls. High percentage of CD4+CD45RO+ T cells was also significantly associated with extraarticular manifestations. Patients with the sicca syndrome had significantly higher ratio of CD5+ B cells than patients without or with other types of extraarticular manifestations. CONCLUSION: Different disease manifestations in RA may be associated not only with certain RF isotypes and RF isotype combinations but also with changes in lymphocyte subsets in the blood. The relative increase of CD4+CD45RO+ T cells in the blood of IgA RF positive patients with RA might reflect preferential recruitment of CD8+CD45RO+ T cells to inflammatory sites.

Adult↗
PubMed1996

A collagen binding protein from Lactobacillus reuteri is part of an ABC transporter system?

The gene coding for a collagen binding protein from Lactobacillus reuteri NCIB 11951 was cloned and sequenced. A genomic lambda library was constructed and recombinant plaques were screened using antisera raised against purified collagen binding proteins from the same L. reuteri strain. The positive plaques were subjected to sodium dodecyl sulfate-polyacrylamide gel electrophoresis and Western blot analysis, which revealed the expression of a 29 kDa protein, which reacted with the antisera and bound 125I-labelled type I collagen. The sequence of the corresponding gene, cnb showed that the collagen binding protein has sequence similarities to the solute binding component of bacterial ABC transporters.

Amino Acid Sequence↗
PubMed1996

Pulmonary artery abnormalities in tetralogy of Fallot and relation to late physical performance.

Preoperative angiograms were reviewed in 86 (52%) of 165 patients who underwent intracardiac repair of tetralogy of Fallot in 1966-1976. The median age at repair was 7 years (range 9 months-55 years). Hypoplasia, stenosis or atresia of the pulmonary and aortopulmonary collateral arteries were present in 58 patients (67%). Hypoplasia of the main pulmonary artery was associated with hypoplasia of the pulmonary artery branches. In patients who received a transannular patch the pulmonary arteries were smaller than in those without patch. Three of five pulmonary artery branch stenoses were located at the site of a previous palliative shunt. The postrepair right ventricular/left ventricular systolic pressure ratio (PRV/LV) measured in the operating room was compared with a predicted ratio based on pulmonary artery dimensions. High PRV/LV was associated with poor prognosis. In survivors the postrepair PRV/LV had fallen significantly 13-26 years later. Work capacity and pulmonary function at follow-up were not influenced by presence of pulmonary artery abnormalities. We conclude that such abnormalities, although common in patients with tetralogy of Fallot, did not per se influence physical performance in long-term survivors.

Adolescent↗
PubMed1996

Healthy houses--perspective on well-being in rural Cambodia.

In a remote area of north-east Cambodia, health is seen more as a matter of living in a spiritually favourable house than of preventing and controlling diseases in individuals. However, this way of seeing things is being influenced towards a more collective view on the one hand, and a more individualistic one on the other.

Attitude to Health↗
PubMed1995

Streptococcal protein MAG--a protein with broad albumin binding specificity.

Protein MAG is a cell surface protein from Streptococcus dysgalactiae which binds alpha 2-macroglobulin (alpha 2M), serum albumin and immunoglobulin G (IgG). In this work protein MAG was expressed in Escherichia coli, purified and analysed for its albumin-binding specificity. The binding of protein MAG to serum albumins of different species origin was studied in a dot-blot assay and compared with the binding of streptococcal protein G, so far the best studied bacterial albumin receptor. The albumin-binding of protein MAG was also characterized using real-time biospecific interaction analysis (BIA), and the ka, kd and the Kaff values for different albumins were determined. Amino acid sequence alignment revealed homology between the albumin-binding domain of protein MAG and earlier described streptococcal albumin receptors including protein G. However, the MAG protein was reactive with serum albumin from bovine, dog, goat, horse, human, mouse, pig, rat and sheep origin and therefore displays a broader albumin-binding profile than protein G concerning the albumins tested in this work. Comparison of the albumin-binding spectrum of protein MAG with the earlier described albumin receptors of various S. dysgalactiae strains and other streptococci, suggests that protein MAG is a new type of albumin receptor.

Amino Acid Sequence↗
PubMed1995

Work capacity and central hemodynamics thirteen to twenty-six years after repair of tetralogy of Fallot.

Exercise tests and cardiac catheterization were performed in 53 patients, 13 to 26 years after intracardiac repair of tetralogy of Fallot. At the time of repair, the median age was 7 years, and 60% of patients with cyanosis had had a previous palliative procedure. The right ventriculotomy was closed without a patch in 21 patients (40%), a patch restricted to the right ventricle was inserted in 18 patients (34%), and in 14 (26%) the patch extended across the pulmonary anulus. At follow-up, 94% of the patients were free of symptoms. Symptom-limited work capacity was 87% of the predicted value (95% confidence limits, 82% to 94%). Work capacity was inversely related to age at follow-up, to right ventricular systolic pressure at rest, and to presence of moderate or severe pulmonary valve regurgitation. Cardiac output in relation to oxygen uptake was reduced in 74% of patients during exercise. In 12 patients (23%), systolic pressure at rest in the right ventricle was 50 mm Hg or higher. Systolic pressure during exercise in the right ventricle was lower in patients without a patch than in those with a patch and was abnormally high in all groups compared with healthy subjects. The ratio of right to left ventricular pressure was significantly lower than measurements taken immediately after repair. An intracardiac left-to-right shunt was present in 6 patients (11%). Three patients required invasive treatment as a result of our follow-up. We conclude that work capacity was moderately reduced 13 to 26 years after repair of tetralogy of Fallot and was adversely influenced by right ventricular hypertension and pulmonary valve regurgitation. Intermittent lifelong surveillance is advocated, because patients without symptoms may have hemodynamic abnormalities that necessitate intervention.

Adolescent↗
PubMed1995

Echocardiographic findings in 83 patients 13-26 years after intracardiac repair of tetralogy of Fallot.

Doppler echocardiography was performed in 83 patients, 13-26 (median 19) years after repair of tetralogy of Fallot. Median age at repair was 7 years (range 9 months-42 years). An outflow patch restricted to the right ventricle was used in 29%, a transannular patch in 27% and the right ventricle was closed without a patch in 44%. Ninety-six percent of the patients were asymptomatic at follow-up. Patients with a transannular patch were younger, had a larger right ventricle and a higher right ventricle to pulmonary artery pressure difference than those without a patch. The average end-diastolic diameter of the right ventricle was larger than normal regardless of type of repair. The thickness of the right ventricular wall was increased in 50%. In 43% of the patients there was persistent hypertrophy of the right ventricular wall despite normalized systolic pressure. The average size and function of the left ventricle were normal although fractional shortening was reduced in 30% of the patients. The aortic root was abnormally large in 48%. Thirty-four percent had moderate or severe pulmonary valve regurgitation. Symptom-limited work capacity was 87% of predicted and was inversely related to age, systolic pressure in the right ventricle. E/A ratio of the left ventricle and use of the transannular patch. We conclude that right ventricular dysfunction and right ventricular outflow obstruction and/or incompetence were common even in asymptomatic long-term survivors after repair of tetralogy of Fallot.

Adolescent↗
PubMed1995

A protein G-related cell surface protein in Streptococcus zooepidemicus.

This work describes the cloning and sequencing of a gene encoding a plasma protein receptor from Streptococcus zooepidemicus. This receptor, termed protein ZAG, is a 45-kDa protein that binds alpha 2-macroglobulin (alpha 2M), serum albumin, and immunoglobulin G (IgG). The IgG-binding activity is located in the C-terminal part of the molecule and is mediated by two repeated domains highly homologous to each other as well as to the corresponding domains in streptococcal type III Fc receptors. The IgG-binding profile of protein ZAG is similar to that previously reported for S. zooepidemicus. Binding to serum albumin is mediated by a short amino acid sequence in the middle of the molecule. This domain shows homology to previously described albumin-binding proteins from streptococci, and the albumin-binding profile of protein ZAG is similar to that of streptococcal protein G. The N-terminal part of protein ZAG, which mediates binding to the plasma proteinase inhibitor alpha 2M, is composed of a unique stretch of amino acids. Protein ZAG competes for the same, or nearby, binding site(s) in alpha 2M as do two recently described Streptococcus dysgalactiae receptors, although the sequences of the alpha 2M-binding domains in these three receptors show only minor sequence similarities.

Amino Acid Sequence↗
PubMed1995

Survival and clinical results up to 26 years after repair of tetralogy of Fallot.

Repair of tetralogy of Fallot was performed on 165 patients (median age 7 years, range 4 months-54 years) in 1966-1976. The 30-day mortality rate was 15%. High postrepair right ventricular/left ventricular pressure ratio (P(RV/LV)) was a predictor of early mortality. Complete atrioventricular block of varying duration, though associated with 42% of the early deaths, was not an independent risk factor in multivariate analysis. The 20-year survival rate (excluding early deaths) was 84%. Reoperation was done in ten patients. Of the 16 late deaths, eight were sudden. Old age at repair and use of transannular patch correlated with risk of late death. Complete atrioventricular block, acyanosis, year of surgery, sex, and P(RV/LV) did not significantly influence long-term survival. Follow-up (median 19, range 13-26 years) comprised 110 survivors, 95% of whom were asymptomatic, 77% in employment, 65% had participated in school athletics and 58% regularly exercised, but 40% did not have regular medical examinations. Operation at age 3-5 years had the most favourable prognosis.

Adolescent↗
PubMed1995

Late sudden deaths after repair of tetralogy of Fallot. Electrocardiographic findings associated with survival.

Of 141 hospital survivors after intracardiac repair of tetralogy of Fallot, eight died suddenly 6-23 years later. Compared with the other 133 patients, these eight were older at operation, with higher post-repair systolic right ventricular pressure and more often complete atrioventricular block; ventricular arrhythmia was diagnosed before death in three cases. In follow-up totalling 2255 patient years, the linearized rate of sudden death was 0.35%/year. The instantaneous risk of sudden death showed continuous increase with the length of follow-up. Of 80 survivors electrocardiographically evaluated 13-26 (median 20) years postoperatively, none had complete block, but 79 had complete right bundle branch block, including seven with left anterior hemiblock. Ventricular extrasystoles were recorded in 1% at rest, in 34% during exercise and in 83% during 24-hour ambulatory monitoring, with Lown Grade > or = II in 27%. Old age and possibly presence of fibrosis and/or fibroelastosis in right ventricular outflow Lown Grade. A patient with Lown grade III died suddenly 2 years after our follow-up. Old age at repair thus was associated with increased risk of late sudden death and with frequent ventricular arrhythmia in long-term survivors.

Adolescent↗
PubMed1994

MAG, a novel plasma protein receptor from Streptococcus dysgalactiae.

The gene encoding a plasma protein receptor from Streptococcus dysgalactiae has been cloned and sequenced. The gene product, with a predicted molecular mass of approx. 44 kDa, binds alpha 2-macroglobulin (alpha 2 M), serum albumin and immunoglobulin G (IgG). By subcloning and expressing various parts of the gene as fusion proteins, we found that the three binding activities reside in discrete domains of the protein. The single IgG-binding domain, localized in the C-terminal part of the molecule, shows high homology to streptococcal type-III Fc receptors. In the middle of the molecule, there is a stretch of 50 amino acids (aa) mediating albumin binding. This region has partial homology with the albumin-binding domains of streptococcal protein G. The alpha 2 M-binding domain is located in the N terminus of the molecule and is composed of a unique aa sequence. We call this trifunctional plasma protein receptor, MAG (binds alpha 2 M, albumin and IgG).

Albumins↗
PubMed1994

The type-III Fc receptor from Streptococcus dysgalactiae is also an alpha 2-macroglobulin receptor.

We have cloned and sequenced the gene for a type-III Fc receptor from a Streptococcus dysgalactiae strain isolated from bovine mastitis and report here the complete sequence of the gene. The 1992-nucleotides-long open reading frame codes for a protein of 664 amino acids with a predicted molecular mass of 72 kDa (including the signal peptide). The C-terminal part of the protein is very similar to other streptococcal type-III receptors but contains five homologous IgG-binding domains compared to two or three in earlier reported Fc receptors of this type. Upstream of the IgG-binding domains, there is a unique sequence containing short repeated motifs. Subcloning different parts of the gene and expressing them as maltose-binding fusion proteins revealed that the upstream part is mediating binding to the plasma proteinase inhibitor alpha 2-macroglobulin after its complex formation with proteases. In contrast to earlier described type-III Fc receptors, this molecule does not bind human serum albumin.

Amino Acid Sequence↗
PubMed1994

Three-dimensional knee joint movements during a step-up: evaluation after anterior cruciate ligament rupture.

The three-dimensional motions of the knee were analysed during closed kinetic chain knee extension in 13 patients with unilateral chronic injury of the anterior cruciate ligament. The patients ascended a platform, and serial stereophotogrammetric roentgenograms were exposed from about 100 degrees of flexion to full extension. From a position of about 100 degrees of knee flexion and 20 degrees of internal rotation, the tibia rotated externally during the extension. Almost no tibial adduction or abduction was observed. The tibial intercondylar eminence translated laterally, distally, and anteriorly relative to the femur. In knees with absence of the anterior cruciate ligament, the intercondylar eminence had a more posterior position compared with the contralateral normal knees. The proximal tibia was used as a fixed reference segment to evaluate the anteroposterior translations of a central point in the femoral condyles. The femoral point was more anteriorly displaced in the injured than in the contralateral knees. This difference might reflect increased activity of the hamstrings in the injured knees, because it was most pronounced at 80 degrees of flexion and decreased with increasing extension. In the sagittal plane, the mean helical axis was positioned close to the femoral insertion of the ligament at 80 degrees of flexion and was displaced distally and anteriorly during extension. In the frontal plane, the axis had a transverse direction at 80 degrees of flexion. At close to full extension, the axis was positioned distally in the lateral condyle and proximally in the medial condyle. In the horizontal plane, the helical axes ran slightly more anteriorly in the medial than in the lateral femoral condyle but changed inclination at close to full extension and became almost parallel to the transverse axis.

Adolescent↗
PubMed1994

Kinematics of successful knee prostheses during weight-bearing: three-dimensional movements and positions of screw axes in the Tricon-M and Miller-Galante designs.

Using roentgen stereophotogrammetric analysis we recorded the three-dimensional movements in six knees with implanted Tricon-M prostheses and ten knees with Miller-Galante prostheses as the patients ascended a platform. Fourteen patients with normal knees were used as controls. The two prosthetic designs displayed decreased internal tibial rotation and the Tricon-M increased valgus rotation. A central point on the tibial articular surface had a more lateral position in the Tricon-M design and a more distal one in the Miller-Galante design compared to normal knees. Increased posterior displacement with increasing flexion was observed in both designs. When the normal knees were extended at full weight-bearing the helical axes mainly shifted inclination in the frontal plane. In the prosthetic knees there was a tendency to anterior-posterior displacement of the axes as extension proceeded, especially in the Miller-Galante design. Translations along the helical axes were larger than normal in the Miller-Galante and smaller in the Tricon-M knees, reflecting differences in constraint of the two designs.

Aged↗
PubMed1994

Pap smear screening and changes in cervical cancer mortality in Sweden.

OBJECTIVES: Age-adjusted incidence of cervical carcinoma has fallen dramatically in Sweden in recent decades. This investigation is an attempt to evaluate the effectiveness of the gynecologic Pap smear screening program in terms of reduction of mortality from cervical cancer. METHODS: Cervical cancer mortality trends in relation to age, calendar period, county and degree of screening activities in the population were analyzed. Multiplicative Poisson regression models were utilized. The reduction of mortality was attributed to the activities of cervical screening. RESULTS: The analysis gave a calculated 53% reduction in cervical cancer mortality (95% confidence limits 23-72%), attributable to screening. CONCLUSIONS: The study supports the hypothesis that gynecological Pap smear screening has had an important impact on the reduction in cervical cancer mortality.

Adult↗
PubMed1994

Patient age as a prognostic factor in prostate cancer.

Whether patient age per se is a prognostic factor of significance in prostate cancer is controversial. To investigate this issue age-specific relative survival was analyzed, and the number of years lost due to this disease was calculated in a large and unselected cohort of 6,890 prostate cancer patients diagnosed between 1971 and 1987 in the northern region of Sweden. The tumor grade was derived from filed notification forms, which showed 26.4% well (grade 1), 40.0% moderately (grade 2) and 17.7% poorly (grade 3) differentiated tumors. There was an overrepresentation of grade 3 tumors among the youngest patients. The age-specific relative survival rate did not differ significantly among different age groups and slight differences almost vanished when adjusting for tumor grade. This finding does not support the view that tumors appearing in younger patients are more aggressive per se. However, loss of life expectancy differed significantly among all age classes and in all 3 grades. In patients with grade 1 tumors the years lost due to prostate cancer ranged from 11.0 to 1.2 in the youngest and oldest age strata, even though the relative survival was approximately 0.70 in all age classes. It was concluded that even if relative survival is constant with patient age, the absolute impact of prostate cancer at different ages varied substantially as indicated by loss of life expectancy. This finding might indicate that younger prostate cancer patients should be given more aggressive treatment than older patients.

Age Factors↗