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J Kongerud

Publications and source records attributed to J Kongerud.

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

Predictive factors for the development of rubeosis following proton beam radiotherapy for uveal melanoma.

AIMS/BACKGROUND: Proton beam radiotherapy can effectively treat primary uveal melanomas of any size. Some patients, however, develop adverse late effects following treatment and the purpose of this study was to determine which factors give rise to a poor local outcome. METHODS: The hospital records from a first cohort of 127 patients treated by protons from 1989 to 1992 were reviewed retrospectively. The presence of rubeosis was selected as a measure of significant ocular damage. Split file analysis was performed with 73 cases forming a test group with the remaining 54 cases acting as a validation group. RESULTS: Large tumour size and the presence of retinal detachment were significant, independent risk factors for developing rubeosis for both the test and validation groups. These factors also predicted subsequent enucleation for uncontrolled ocular pain. Patients with tumours too large to plaque and with an associated retinal detachment had a 90% chance of developing rubeosis within 4 years of proton beam radiotherapy. CONCLUSIONS: Patients with a uveal melanoma too large for plaque therapy and an associated retinal detachment run a very high risk of developing rubeosis after proton beam radiotherapy and one third of individuals developing rubeosis required enucleation for pain even if local tumour control was satisfactory.

Adult↗
PubMed1997

Weight gain during the first year of life in relation to maternal smoking and breast feeding in Norway.

OBJECTIVE: To assess the weight gain during the first year of life in relation to maternal smoking during pregnancy and the duration of breastfeeding. DESIGN: This was a one year cohort study. SETTING: The city of Oslo, Norway. PARTICIPANTS: Altogether 3020 children born in Oslo in 1992-93. Children were divided into three groups as follows: 2208 born to non-smoking mothers, 451 to mothers who were light smokers (< 10 cigarettes per day), and 261 to mothers who were heavy smokers (> or = 10 cigarettes per day). MAIN RESULTS: The mean birth weights were 3616 g, 3526 g, and 3382 g and 1 year body weights were 10,056 g (gain 6440 g per year), 10,141 g (6615 g), and 10,158 g (6776 g) in children of non-smoking and light and heavy smoking mothers respectively. Cox regression analysis showed that children of heavy smokers were 2.0 (95% confidence interval, 1.7, 2.3) times and children of light smokers 1.3 (1.2, 1.5) times more likely to have stopped breast feeding during their first year of life compared with children whose mothers were non-smokers. Linear regression analysis, adjusting for confounders, showed that weight gain was slower in breast fed children than in those who were not breast fed (-38 g (-50, -27) per month of breast feeding). Compared with children of non-smokers, the adjusted weight gain was 147 g (40, 255) per year greater in children of light smokers and 184 g (44, 324) per year in children of heavy smokers. CONCLUSION: Children catch up any losses in birth weight due to maternal smoking, but some of the catch up effect is caused by a shorter duration of breast feeding in children of smoking mothers.

Birth Weight↗
PubMed1997

Relation between decline in FEV1 and exposure to dust and tobacco smoke in aluminium potroom workers.

OBJECTIVES: To investigate the relation between pulmonary function and occupational exposure in aluminium pot operators. METHODS: 2795 observations were obtained in 630 workers over six years of follow up. An autoregressive method of analysis was used. RESULTS: After adjustment for FEV1 in the three previous years, the effect of smoking v no smoking on FEV1 was -43.1 ml, 95% confidence interval (95% CI) -72.3 to -13.9. Similarly, an increase in the exposure to particulates by 1 mg/m3 corresponded to a decrease in FEV1 of -11.9 ml, 95% CI -19.9 to -3.9. Age was a significant predictor of both FEV1 and FVC. CONCLUSION: Exposure to particulates in aluminium potrooms seems to increase the decline in FEV15 thereby increasing the risk of development of chronic obstructive lung disease in pot operators.

Adolescent↗
PubMed1997

Exposure to hydrogen fluoride: an experimental study in humans of concentrations of fluoride in plasma, symptoms, and lung function.

OBJECTIVES: To study the absorption of inhaled hydrogen fluoride (HF) by measuring plasma fluorides and HF concentrations in the breathing zone during exposure to HF. A possible dose-effect relation was investigated by following airway symptoms and lung function-that is, forced expiratory volume in one second (FEV1) and forced vital capacity (FVC)-during and after exposure to HF. METHODS: 20 healthy, male volunteers were exposed for one hour to constant HF concentrations that ranged from 0.2 to 5.2 mg/m3; these concentrations are known to occur among potroom workers in the primary aluminium industry. Plasma fluorides were analysed before, during, and after exposure. Symptoms from the eyes and the upper and lower airways were registered and graded from 1 to 5 with a standardised questionnaire. RESULTS: The total symptom score was significantly increased at the end of exposure for all the subjects as a group (P < 0.01) and for the group exposed to HF below the present Norwegian standard for total fluorides 0.6 mg/m3 (P = 0.05). No change was detected in FEV15 although a significant decrease was found in FVC in the group exposed to fluorides below the hygienic standard (n = 9) and for the entire group (n = 23). Almost all the symptoms had disappeared four hours after the end of exposure. Symptom scores from the upper airways were significantly correlated with the HF concentration (r = 0.62, P = 0.002), the change in plasma fluoride concentration (delta C) (r = 0.51, P = 0.01), and the maximum plasma fluoride concentration (Cmax) (r = 0.42, P = 0.05). A significant correlation was also found between the total symptom score for airways and the HF concentration. CONCLUSIONS: The present study showed a strong relation between inhaled HF and concentrations of fluoride in plasma. Upper airway and eye symptoms occurred after one hour of exposure to HF even when below the Norwegian hygienic standard for fluorides.

Administration, Inhalation↗
PubMed1996

[Meconium ileus-equivalent in adult patients with cystic fibrosis].

Gastrointestinal complications of cystic fibrosis are becoming more common because patients with cystic fibrosis are living longer. There are 227 cystic fibrosis patients in Norway today, almost half of whom are more than 18 years old. Meconiumileus-equivalent is a complication which increases with age. It is a term used to describe partial or complete intestinal obstruction occurring in patients with cystic fibrosis. It results from abnormally viscid mucofaeculent material in the terminal ileum and right proximal colon. Some patients may experience acute complete obstruction, but most of them suffer from chronic partial obstruction, with recurring colicly abdominal pain and some distension. Of 70 adult cystic fibrosis patients at Aker hospital over a seven year period, 26% had symptoms and signs of this disorder. Conservative treatment is preferable, and surgery should be avoided.

Abdomen, Acute↗
PubMed1996

[Assessment of causal relationship in work-related pulmonary diseases. An epidemiological approach].

A competent assessment of causal relationships in the case of work-related lung disorders depends on correct diagnosis, a detailed occupational history and updated epidemiological knowledge about causal relationships, obtained from the literature. Assessments for purposes of compensation demand, in addition, an explicit choice of methods for calculating causes, before a meaningful attempt can be made to weight the various factors in and outside the working environment. If adequate epidemiological knowledge is available, the causal probability, based on the etiological fraction among the exposed persons (attributable risk) may be a useful tool for apportioning the different causal factors.

Disability Evaluation↗
PubMed1996

[Principles for assessment and diagnosis of work-related pulmonary and pleural diseases].

Proposals for diagnostic methods and clinical evaluation of occupational lung and pleural diseases have been worked out by a Working Group appointed by the Norwegian Thoracic Society and the Norwegian Society of Occupational Medicine. The management of this group of diseases demands both an evaluation of occupational exposure and a specific pulmonary diagnosis. Recommendations were made especially for obstructive, interstitial, and malignant diseases.

Disability Evaluation↗
PubMed1996

[Expert statement and assessment of medical impairment in work-related pulmonary disease].

The Norwegian Societies of Thoracic Medicine and Occupational Medicine established a working group to standardise diagnostic procedures and evaluation of work-related respiratory disorders. In cases of suspected work-related diseases the physician may be asked by the National Insurance Administration or an insurance company to make a statement which will be one of the documents used to decide the patient's right to compensation benefit. We discuss the role of the physician as an independent expert. This is different from his role as clinician. The statement should include a balanced presentation of information from different sources, including health and occupational history, and the employer's information about the work environment (quantitative and qualitative exposure data). The statement must also include the results of a clinical examination and an assessment of functional status based on objective tests. The paper contains recommendations for evaluation of permanent impairment in light of the present Norwegian laws and regulations.

Air Pollutants, Occupational↗
PubMed1996

Deaths from active tuberculosis: can we rely on notification and mortality figures?

SETTING: Notification rates and mortality are the main indicators in the epidemiology of tuberculosis. While errors in case notification are known to be considerable, the quality of the data on deaths is largely unknown. OBJECTIVE: To validate the quality of data on deaths from active tuberculosis. DESIGN: We compared deaths from active tuberculosis in Statistics Norway with the National Tuberculosis Register (NTR) and cases found by autopsy in two Norwegian counties in 1977-1989. We also assessed the diagnostic classification and inclusion criteria for tuberculosis. RESULTS: 110 patients were entered into the study. We excluded 30 of 106 patients in Statistics Norway, primarily because of inactive tuberculosis (16) or minimal lesions (7). We found an additional 20 patients in the NTR and 14 more from autopsy reports. These missing cases were registered in Statistics Norway with a different diagnosis (28), inactive tuberculosis (4) or not found (2). Nineteen of them were diagnosed with tuberculosis by autopsy and five by cultures reported after death. We altered the diagnostic classification of underlying cause in 14% and found tuberculosis to be the underlying cause in 65 patients. CONCLUSION: The mortality rate from active tuberculosis in Statistics Norway was fairly correct, but one-third were under-reported and one-third over-reported. The mortality rate includes only half of all the deaths from active tuberculosis. All the cases in which active tuberculosis is mentioned on the death certificate are a clearer indication of tuberculosis deaths.

Autopsy↗
PubMed1996

Cardiopulmonary sequelae after treatment for Hodgkin's disease: increased risk in females?

BACKGROUND: The treatment of Hodgkin's disease (HD) involves irradiation and chemotherapy. Both modalities may cause heart and lung injury. We aimed to assess 1) the occurrence of such injury, 2) the extent to which combined versus single-organ-affection resulted in disability, and 3) whether determinants for cardiopulmonary injury could be identified. PATIENTS AND METHODS: A national cohort (n = 116) of HD patients (mean age 37 +/- 7 (SD) years, 67 males) was examined by interview, echocardiography, bicycle exercise test and lung function tests, 5-13 years after mediastinal irradiation with or without chemotherapy. RESULTS: Cardiac, pulmonary or combined sequelae occurred, respectively, in 21%, 15% and 19% of the patients affecting 75% of the females versus 41% of the males (P < 0.001). Of the patients with combined sequelae, 27% were disabled versus 4% of the rest (P < 0.05). Combined sequelae was associated with dyspnoea (P < 0.001) and reduced maximal exercise heart rate (P < 0.05). Compared to males, females had an increased risk of heart valve regurgitation (46% versus 16%, P < 0.001), pericardial thickening (22% versus 10%, P = 0.07) and reduced gas transfer (41% versus 22%, P = 0.03). Female gender was a significant risk factor for cardiac and/or pulmonary sequelae (OR 6.1, 95% CI 2.4-15.7), whereas age, follow-up period, smoking habits, histology, bulky mediastinal disease, radiation dose and chemotherapy were not. Mean exercise work capacity and O2-saturation were within normal limits. CONCLUSIONS: Although cardiac and/or pulmonary sequelae were detected in more than half of the patients, only combined injury was associated with disability, dyspnoea and reduced performance. Females had an increased risk of cardiopulmonary sequelae, which could not be explained by treatment-related differences between the genders.

Adult↗
PubMed1996

Increased variability in bronchial responsiveness in aluminum potroom workers with work-related asthma-like symptoms.

In a longitudinal study, we studied the variability in bronchial responsiveness (BR) to methacholine in aluminum potroom workers suffering from work-related asthma-like symptoms (WASTH) and in symptom-free workers. In the index group, 26 men suffering from WASTH were selected from a cross-sectional survey. The reference group comprised 45 symptom-free men recruited from the enrollment of new employees. Bronchial responsiveness was expressed as the dose-response slope (DRS) of the line through origin and the last data point. The standard deviation of the log-transformed DRS was positively associated with symptom score (P = .012) and the mean BR (P < .001). Our results indicate that the severity of respiratory symptoms in aluminum potroom workers with WASTH reflects the variability in BR.

Adult↗
PubMed1996

Increased risk of heart valve regurgitation after mediastinal radiation for Hodgkin's disease: an echocardiographic study.

OBJECTIVE: To assess by echocardiography the occurrence and degree of late cardiac sequelae after treatment for Hodgkin's disease by radiation and chemotherapy. PATIENTS AND METHODS: In Norway from 1980 to 1988, 129 patients < 50 years old with Hodgkin's disease had curative treatment with mediastinal radiation, with or without chemotherapy. 116 (90%) of these patients (mean (SD) age 37 (7) years, 67 males) were examined by echocardiography 5-13 years after treatment. 40 healthy individuals (mean (SD) age 40 (11), 20 males) were examined as controls. All those examined were in regular sinus rhythm. RESULTS: Grade > 1 (scale 0-3) aortic and/or mitral valvar regurgitation was found in 24% of the patients (15% aortic, 7% mitral, and 2% aortic+mitral), affecting 46% of the females v 16% of the males (P < 0.001). Female gender was a significant risk factor for aortic and mitral regurgitation (odds ratio 4.7, 95% confidence interval 2.0 to 11.2), whereas age, period of follow up, radiation dose, and chemotherapy were not. Thickened pericardium was diagnosed in 15% of the patients. No risk factors were identified. No cases of pericardial thickening or valvar regurgitation grade > 1 were recorded in the control group. Mean values for measured and calculated indices of systolic and diastolic function were within the normal range for patients and controls. The patients had reduced E/A ratio compared with the healthy controls (E/A 1.1 v 2.0, P < 0.001). CONCLUSIONS: Abnormal left sided valvar regurgitation was detected in one fourth of the patients, affecting the aortic valve in more than half of the cases. Females had an increased risk of valvar regurgitation. Echocardiographic screening after high-dose mediastinal radiation is recommended.

Adult↗
PubMed1996

Breastfeeding, maternal smoking and lower respiratory tract infections.

The objective of the study was to assess the relationship between breastfeeding and lower respiratory tract infections (LRTIs) during the first year of life, with special reference to maternal smoking. A cohort of 3,754 children born in 1992-1993 in the City of Oslo, Norway was recruited and data were collected at birth, 6 and 12 months of age. Complete information was obtained from 3,238 children (follow-up rate 86%). The main outcome was an episode of a LRTI, such as pneumonia, bronchitis or bronchiolitis, based on a self-administered questionnaire addressed to parents when the child was 6 and 12 months old. The outcome was specified as physician-diagnosed. In logistic regression analysis adjusting for confounding, maternal smoking increased the risk of LRTIs in children breastfed for 0-6 months (odds ratio (AOR) 1.7; 95% confidence interval (95% CI) 1.2-2.4), but not essentially when the child was breastfed for more than 6 months (AOR 1.1; 95% CI 0.7-1.6). Short-term breastfeeding (0-6 months) and no maternal smoking was related to an adjusted AOR of LRTIs of 1.3 (95% CI 1.0-1.7), and short-term breastfeeding combined with maternal smoking was related to an adjusted AOR of 2.2 (95% CI 1.6-3.1), as compared with long-term breastfeeding and no maternal smoking. The present study indicates a protective effect of long-term breastfeeding on the risk of lower respiratory tract infection during the first year of life. The results suggest that the protective effect is strongest in children exposed to environmental tobacco smoke.

Adult↗
PubMed1996

Fetal exposure to tobacco smoke products: a comparison between self-reported maternal smoking and concentrations of cotinine and thiocyanate in cord serum.

BACKGROUND: The objective of the study was to assess the relationship between maternal smoking habits and biomarkers of tobacco smoke measured in cord serum. METHODS: The study population comprised 202 mothers, 42 daily smokers, 24 occasional smokers and 136 nonsmokers. Information on maternal smoking habits was collected in a self-administered questionnaire at birth and compared with cotinine and thiocyanate concentrations in cord serum. RESULTS: In linear regression analysis, a unit increase in daily cigarette smoking corresponded to a 4.4 ng/ml (95% CI: 1.1-7.6) increase in cotinine concentration and 2.3 mumol/l(0.8-3.8) in thiocyanate. A cut-off point of 14 ng/ml cotinine separated well between daily smokers (88% above) and nonsmokers (96% below), but revealed a classification problem in occasional smokers (46% above). CONCLUSION: Cord serum cotinine and thiocyanate concentrations are related to daily smoking rate during pregnancy, but these concentrations vary considerably among occasional smokers. Detailed information on smoking habits is the key issue in understanding the adverse fetal effects of occasional smoking during pregnancy.

Adult↗
PubMed1996

Allergen sensitization and exposure to irritants in infancy.

We investigated the relationship between residence in the neighbourhood of an aluminium smelter and the prevalence of atopy in schoolchildren (7-13 years of age). Atopy was assessed in 556 of the 620 participants by a skin prick test with eight common aeroallergens. The median exposures to sulphur dioxide and fluoride during the pollen season in the age interval 19-36 months were 24 and 3.1 micrograms/m3 in the spring and 20 and 3.3 micrograms/m3 in the summer, respectively. The odds ratio (OR) of having atopy was 2.0 (95% CI: 1.2-3.3) in those children who had lived in the index area for 7 years or more compared with those who had lived there less than 7 years (cumulative effect). The OR of atopy was 2.5 (1.4-4.4) in those who had lived in the index area during the age interval of 19-36 months compared with rural residence during this age-interval (age-specific effect). When the age-specific effect and the cumulative effect were compared in the same logistic model, the former decreased to 1.1 (0.4-3.0), whereas the latter was 2.2 (0.7-6.6). The results indicate that exposure to these low levels of irritants during early childhood increases allergen sensitization in children.

Adolescent↗
PubMed1996

The use of isolated lung cells in in vitro pulmonary toxicology: studies of DNA damage, apoptosis and alteration of gene expression.

Isolated lung cells constitute a valuable system for studying mechanisms involved in chemically induced toxicity in the lung. Different lung cells isolated from various species may be studied. Bronchiolar Clara and alveolar type 2 cells produce important lung-specific proteins, hold a major role in the metabolism of xenobiotics and serve as progenitor cells for other lung cell types. They are possible target cells in lung carcinogenesis. Alveolar macrophages play an important role in lung defence and in inflammatory responses. In the present study we have characterised chemically induced DNA damage, apoptosis, changes in cell cycle progression, transformation and alterations in gene expression in these specific lung cells isolated from rat, rabbit and human. Major differences between the cell types and the various species in the induction of DNA damage by chemicals were found, as measured by the 32P-postlabelling and alkaline filter elution techniques. Benzo(a)pyrene and hydrogen fluoride were found to induce apoptosis in the isolated cells as measured by microscopical analysis and flow cytometry. The function of various important tissue- or cell type specific proteins (CYP 2B1, Clara cell protein) and/or cellular signal transduction pathways constitute important targets that may be affected by exposure to toxic compounds. Using immunological and molecular techniques the differential expression of specific proteins/RNAs and their activity can be studied. Among other proteins, c/ebp is involved in the regulation of transcription at the end of signal pathways. The protein is differentially expressed in rat lung cells and thus could be suitable for studying differential toxic effects in various lung cells. In humans, bronchoalveolar lavage (BAL) fluid from human volunteers can be readily obtained and examined after exposure to different chemical compounds. An increase in the percentage of CD3-positive cells (T-lymphocytes) was found after exposure to hydrogen fluoride. The number of certain cell types and cytokines may be used to estimate the degree of inflammatory reaction. In conclusion, the use of in vitro data including the use of specific, primary human lung cell types may contribute considerably to the quality of risk assessment, together with in vivo data from animals and man.

Animals↗
PubMed1995

Relation of exposure to airway irritants in infancy to prevalence of bronchial hyper-responsiveness in schoolchildren.

To find out whether exposure to sulphur dioxide during infancy is related to the prevalence of bronchial hyper-responsiveness (BHR), we studied schoolchildren (aged 7-13 years) from two areas of Norway--a valley containing a sulphur-dioxide-emitting aluminium smelter and a similar but non-industrialised valley. Bronchial responsiveness was assessed in 529 of the 620 participants. The median exposures to sulphur dioxide and fluoride were 37.1 micrograms/m3 and 4.4 micrograms/m3 at ages 0-12 months and 37.9 micrograms/m3 and 4.4 micrograms/m3 at 13-36 months. The risk of BHR increased with exposure to sulphur dioxide and fluoride at these ages; the odds ratio for a 10 micrograms/m3 increase in sulphur dioxide exposure at 0-12 months was 1.62 (95% CI 1.11-2.35) and that for a 1 microgram/m3 increase in fluoride exposure was 1.35 (1.07-1.70) at 0-12 months and 1.38 (1.05-1.82) at 13-36 months. Exposure to these low concentrations of airway irritants during early childhood is associated with an increased prevalence of BHR in schoolchildren.

Adolescent↗