Biomedical subjects

H Jonsson

Publications and source records attributed to H Jonsson.

At least 55 records · Page 3Linked to original sources

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↗

PubMed1994

Chronic lymphocytic leukemia: a retrospective study of 122 cases.

During the period 1978-1982 in the three northernmost countries of Sweden all 143 patients with a registered diagnosis of chronic lymphocytic leukemia (CLL) were retrospectively analyzed. After re-evaluation, 122 cases remained in the study. The mean age was 71 years and the male/female ratio was 2.2:1. Sixty-one patients were Binet stage A, 29 stage B and 32 stage C. The diagnosis CLL was made after routine check-up for other diseases in most of the patients and they had no symptoms from the CLL. The median survival was 51 months and there were no differences in crude survival according to stage or other prognostic factors such as hemoglobin, lymphocytes or thrombocytes in peripheral blood. Analysis of CLL as a cause of specific mortality showed the stage of CLL to have a slight prognostic significance. This could be due to the fact that many of the patients suffered from other serious diseases, allowing the detection of early stage or advanced CLL with no symptoms.

Adult↗

PubMed1994

Coping style in relation to the consumption of factor concentrate in HIV-infected hemophiliacs during the years after their infection became known.

A psychosocial investigation offered to all HIV-infected men with moderately severe or severe hemophilia in Sweden was made in 1986. Most of these men had been infected in the years 1980-1984 and told about their own infection in 1985. A noninfected group of hemophiliacs was used as a reference group in the psychosocial investigation. A psychosocial prognosis was made on the basis of the coping style observed by means of the Coping Wheel. Among subjects who showed evidence of a passive-pessimistic copying style, there was a significant decrease in the number of factor concentrate units received in 1987 and 1988. Among subjects in the group with a more active-optimistic coping style, there was a tendency of increasing the use of factor concentrate during the years after the HIV-infection became known. This result indicates that awareness of HIV-infection may influence specific hemophilia behavior among subjects with passive-depressed copying style.

Adaptation, Psychological↗

PubMed1994

Psychosocial self-prognosis in relation to mortality and morbidity in hemophiliacs with HIV infection.

HIV-infected hemophiliacs participated in a psychosocial prognosis study. The Coping Wheel was filled out 1-2 years after the subjects had been told that they were HIV-infected and between 1 and 7 years after they had become infected. The number of significant signs of disease as well as mortality were recorded during the years following the psychosocial measurements. These measures were related to three measures of anticipated future activities derived from the Coping Wheel, namely 'number of activities for oneself', 'number of activities with others' and a combined measure 'number of activities for oneself in relation to number of activities with others'. The results indicated that the subject's own psychosocial prognosis added to the prediction of mortality. The most important psychosocial factor was the combined measure: those with few anticipated activities for oneself in relation to activities with others had a greater likelihood of dying soon during follow-up. The latter prediction was true even after adjustment for age and condition of the immune system (CD4 count) at the start of follow-up. The conclusion is that the Coping Wheel, applied as in the present examination, may be of help in prognosis and in identifying psychosocial needs in patients with HIV infection.

Adaptation, Psychological↗

PubMed1994

Effects of dietary intervention on serum lipids in factory workers.

OBJECTIVE: To assess the effect of workplace-oriented dietary intervention on serum lipids. DESIGN: A cohort study. Screening for blood lipids and subsequent dietary intervention performed at a ferro-alloy factory where all the workers have at least one meal per working day served by the factory kitchen. SETTING: Employees at Grundartangi ferro-alloy factory, Iceland. SUBJECTS: From 1 June 1989 to 1 June 1991, 155 workers participated in the screening and prevention programme. INTERVENTION: Changing the food served by the kitchen to 200 workers by lowering the total number of calories and increasing the content of fibre and unsaturated fats in the diet. RESULTS: The mean serum cholesterol was lowered from 6.64 to 6.09 mmol/l or by -8.28% for the whole group (p < 0.001) after two years of intervention. In the subgroups studied, serum high density lipoprotein (HDL) increased (p < 0.001), whereas serum low density lipoprotein (LDL) decreased. Cholesterol/HDL and LDL/HDL ratios were reduced. General dietary habits seemed to change in a favourable way. No significant change occurred in body mass index or smoking habits, and there was little effect on exercise habits. CONCLUSION: Workplace dietary intervention seems to be effective in reducing cardiovascular risk factors. Information provided to the kitchen staff is of importance, as well as information given to the employees, in order to obtain beneficial results from dietary change.

Adult↗

PubMed1994

Prostate cancer in northern Sweden. Incidence, survival and mortality in relation to tumour grade.

In order to study changes in incidence, survival and mortality of prostate cancer in relation to morphological grade, we analysed all incident cases of prostate cancer in Northern Sweden during three 2-year periods (1974-1975, 1980-1981 and 1986-1987). The age-adjusted incidence increased by 35% from 1974-1975 to 1986-1987, but there was only a minor increase in the mortality rates. The increase in incidence was mainly due to well-differentiated (G1) and moderately differentiated (G2) tumours, whereas the incidence of poorly differentiated (G3) tumours remained stable. The 5-year relative survival rate increased significantly from 1974-1975 to 1986-1987. The relative survival rate for each tumour grade was, however, almost stable over the studied time period. After adjustment for tumour grade the differences in relative survival rate diminished. We believe that the most likely explanation for these changes in incidence, survival and mortality is enhanced detection of tumours with more favourable histology as a result of a more frequent use of the diagnostic tools available.

Aged↗

PubMed1994

Pulmonary function thirteen to twenty-six years after repair of tetralogy of Fallot.

Lung function was evaluated in 68 patients 13 to 26 (median 19) years after repair of tetralogy of Fallot. Age at repair was 7 years (9 months to 42 years) and 51% had a palliative shunt. An outflow patch was inserted in 56%. Median vital capacity was 84% of predicted, forced expiratory volume in 1 second 83%, maximal voluntary ventilation at 40 breaths/min 70%, and diffusing capacity for carbon monoxide 77% of predicted. Scintigraphy demonstrated abnormal pulmonary perfusion in 86%. Average right lung perfusion was 57% (predicted 52%). Regional hypoperfusion could in some patients be explained by previous palliative shunt, pulmonary artery obstruction, or presence of aortopulmonary collaterals. Median symptom-limited work capacity was 82% (95% confidence limits 78% to 90%) of predicted. Twenty-eight physically active patients had high values for symptom-limited work capacity, vital capacity, forced expiratory volume in 1 second, and maximal voluntary ventilation at 40 breaths/min compared with those of inactive patients. Lung function variables were related to physical exercise and previous palliative shunt. Moderate or severe pulmonary valve incompetence had negative but not significant influence on lung function. There was no significant influence of acyanosis before repair, use of transannular patch, duration of follow-up, or smoking. We found moderately reduced work capacity and lung function late after repair of tetralogy of Fallot that did not cause symptoms. Lung function variables were high in young active male patients and low in patients with previous palliative shunt. A better lung function in active patients indicates that physical activity should be encouraged after repair of tetralogy of Fallot.

Adolescent↗

PubMed1994

Over-the-top or tunnel reconstruction of the anterior cruciate ligament? A prospective randomised study of 54 patients.

We report a review of 54 patients with chronic anterior cruciate ligament rupture treated by patellar-quadriceps tendon graft augmented with polypropylene braid (Kennedy-LAD). The femoral placement of the graft was randomised to either a modified over-the-top (OTT) or a tunnel position obtained by an isometric drill guide (ISO). At the two-year follow-up both procedures had resulted in improvement of subjective knee function and activity level. Stereoradiographic measurements showed reduction of anteroposterior laxity to near normal in about one-third of the patients, but muscle strength and objective functional performance showed little or no changes. The OTT group had better subjective knee function. We were unable to confirm the theoretical advantages of the use of the drill guide, partly because it provided a tibial tunnel which was too anterior.

Adult↗

PubMed1993

Clustering of neutrophil leucocytes in serum: possible role of C1q-containing immune complexes.

Clustering activity for neutrophil granulocytes was generated in pooled normal human serum (NHS) by incubation of the serum with preformed IgG aggregates, but not in heat-treated NHS (56 degrees C, 30 min), indicating that the function was complement-dependent. Judging from results of experiments with complement-deficient sera, and serum depleted of C1q, factor D and properdin, recruitment of the complement system beyond C1 was not required for induction of the activity. Zymosan treatment of NHS resulted in some neutrophil clustering activity, but recombinant C5a had a limited effect. C1q added to heat-treated NHS in conjunction with performed IgG aggregates supported neutrophil clustering in a dose-dependent manner. The serum C1q inhibitor, a chondroitin 4-sulphate proteoglycan known to interact with the collagenous part of C1q, clearly reduced neutrophil clustering in heat-treated NHS supplemented with C1q and IgG aggregates. The C1q inhibitor also reduced the inherent neutrophil clustering activity of some sera from patients with systemic lupus erythematosus (SLE). Neutrophil clustering activity in SLE serum was earlier shown to be inversely related to the number of circulating neutrophils in vivo. Although the precise mechanisms remain unclear, we propose that C1q-containing immunoglobulin complexes mediate neutrophil clustering through C1q receptors, and that this might contribute to pathogenesis of immune complex diseases such as SLE.

Antigen-Antibody Complex↗

PubMed1993

Non-Hodgkin's lymphoma in northern Sweden. A retrospective analysis of morphologic diagnosis and stage in a material from the Swedish Cancer Registry.

Morphologic diagnosis and clinical stage were studied in a retrospective material of non-Hodgkin's lymphomas comprising 352 patients diagnosed 1978 until 1982 and reported to a regional cancer registry. Classification was made according to the original Kiel classification. Patients who could be classified as belonging to low- (46%) or high-grade (47%) malignancy groups (n = 337) were further studied. The median age was high, 65 years, which probably reflects the low degree of selection in a regional register material compared to most hospital register-based materials. The proportion of stage I cases was rather high, in low-grade lymphomas 24%, and in high-grade 39%, which can be attributed to incomplete staging procedures in old patients. The aim of the study was to illustrate the distribution according to morphologic subclasses and clinical features in a material with a low degree of patient selection.

Adolescent↗

PubMed1993

Non-Hodgkin's lymphoma in northern Sweden. Prognostic factors and response to treatment.

A total of 352 cases of non-Hodgkin's lymphoma reported to the Cancer Registry of Northern Sweden during 1978-1982 were retrospectively analysed. After morphologic review, 327 cases classifiable as low (n = 162) or high-grade (n = 165) according to the Kiel classification remained for further study. The purpose of the study was to evaluate the interrelations between some variables and their bearing on prognosis in an almost unselected clinical material. Age, morphological grade of malignancy, clinical stage, systemic symptoms, bulk of disease and serum lactate dehydrogenase (LDH) level turned out to be associated with the clinical outcome in terms of response to treatment, disease-free survival and survival. In the heterogenous group of low-grade lymphoma, six pretreatment characteristics were negatively associated with survival in a univariate analysis, namely; stage II-IV, systemic symptoms, bone marrow infiltration, two or more extranodal sites, elevated LDH and age above 65 years. In high-grade lymphoma, stage II-IV, bone marrow infiltration and elevated LDH predicted a worse prognosis in a multivariate analysis. The impact of the number of these prognostic factors on survival in high-grade lymphoma was demonstrated.

Adolescent↗

PubMed1993

Laxity after cruciate ligament injury in 94 knees. The KT-1000 arthrometer versus roentgen stereophotogrammetry.

We examined 94 knees with chronic anterior cruciate ligament injuries, 55 of which had been operated with ligament reconstruction, using the KT-1000 arthrometer (89 N anterior force) and roentgen stereophotogrammetry (RSA, 150 N anterior, 80 N posterior force). In intact knees the tibial displacement did not differ between the methods. In injured knees, operated or not, the KT-1000 recorded smaller AP translations and side-differences than RSA. Thus, the stabilizing effect of reconstructive surgery may be overrated, if evaluated with the standard KT-1000 technique.

Adolescent↗

PubMed1993

Surgical treatment of vertebral metastases.

Metastatic tumors often spread to the vertebral column. When the mechanical strength of a vertebra is decreased as a result of tumor-induced bone destruction, a pathologic fracture may occur. Such a fracture is often associated with severe pain. If it occurs in the thoracic or upper lumbar region, there is a major risk of paraplegia if the fractured vertebral body is displaced into the spinal canal. Metastases in the vertebral column also can cause neurologic symptoms due to direct infiltration of the tumor into the spinal canal. Due to recent advances in spinal surgery, effective help often can be provided to these patients. The extent and type of surgical intervention, however, must be carefully considered in each individual case.

Fracture Fixation, Internal↗