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J Olofsson

Publications and source records attributed to J Olofsson.

At least 37 records · Page 2Linked to original sources
PubMed1999

[Surgical treatment of endocrine ophthalmopathy].

Thyroid ophthalmopathy is an inflammatory disorder of the extraocular muscles, orbital fat and orbital connective tissue that is most commonly seen in patients with Graves' hyperthyroidism. Inflammation is accompanied by deposition of extracellular matrix components, in particular glycosaminoglycans. The increase in the volume of the orbital contents may lead to periorbital swelling, extraocular muscle dysfunction, disfiguring proptosis, exposure keratitis, increased intraocular pressure and optic nerve compression. In many cases, surgical treatment is necessary for the rehabilitation of patients. In this report, we present a series of patients to illustrate relevant procedures and the results of surgical treatment in patients with thyroid ophthalmopathy. The records of all patients (66) with thyroid ophthalmopathy hospitalized in the Department of Ophthalmology, Haukeland University Hospital 1 April 1994-31 March 1998 were retrospectively evaluated. Orbital decompressions were performed in 43 patients (in 17 for compressive optic neuropathy), squint surgery in 13 patients, correction of eyelid retraction in 20 patients, and removal of excessive skin and fat from the eyelids in 11 patients. Average reduction of proptosis was 4 mm after lateral wall resection, and 6 mm after combined medial and lateral wall resection. Visual acuity improved in patients with compressive optic neuropathy to 6/6 or better in 18/20 eyes (postoperative data were not available for all patients), while that of the remaining two eyes was 6/9 and 6/24, respectively. Squint surgery was successful (no diplopia in primary or reading position) in eight patients after one procedure, and in four after two procedures. One patient has been scheduled for a third procedure due to a severe esotropia. In patients with thyroid ophthalmopathy, suboptimal treatment of the thyroid disorder may worsen the ophthalmopathy. 16 patients had their medication adjusted, ten were referred for thyroid surgery, and one for treatment with radioiodine. Treatment of patients with thyroid ophthalmopathy is a therapeutic challenge requiring close collaboration between different specialists. In severe cases, several surgical procedures may be needed. The complication rate is low, however, and for most patients the functional as well as the aesthetic situation is greatly improved.

Adolescent↗
PubMed1999

[Tonsillectomy--day surgery or hospitalization?].

Most current studies show that adenotonsillectomies can be performed safely as day case surgery. We wanted to evaluate patient acceptability of ambulatory surgery. A prospective study was undertaken in order to compare (adeno)tonsillectomies performed on an inpatient and outpatient basis. 104 patients underwent day surgery (adeno)tonsillectomy. 88 patients were treated as inpatients, but would have met the selection criteria for ambulatory surgery if an exception had been made in relation to travel distance. Tonsillectomy is an operation with high postoperative morbidity. Our study shows that patients undergoing day case surgery had better sleep, better oral intake and had less pain during the first postoperative night. The majority of the inpatients considered tonsillectomy performed as day case surgery less tolerable. With adequate information and patient selection, our study showed that most patients prefer day surgery. Questioned two weeks postoperatively, 92% of the patients preferred tonsillectomy performed as a day case procedure. Use of day surgery may improve health care efficiency. At the same time, it may improve quality of care for the patients.

Adolescent↗
PubMed1999

Ex vivo interleukin (IL)-1 beta, IL-6, IL-12 and tumor necrosis factor-alpha responsiveness with monocytes from patients with head and neck carcinoma.

Seventy newly diagnosed Caucasian male patients with head and neck squamous cell carcinomas (HNSCC) were included in the study. All patients were less than 80 years of age, with no cachexia or auto-immune disease, and they were not taking immuno-active medications. Monocytes from these patients were cultured in vitro and supplemented with autologous serum under ex vivo conditions or cultured with serum-free medium. Comparison was made to monocytes from 59 patients with benign HN diseases. Similar physical activity levels prior to testing as well as a minimum stress load were ensured in both groups. Increased monocyte supernatant levels were determined under ex vivo conditions of interleukin-1 beta (IL-1 beta), interleukin-6 (IL-6) and tumor necrosis factor (TNF)-alpha, but not of interleukin-12 (IL-12) with endotoxin stimulated monocytes of HNSCC patients compared to control conditions. Increased monokine levels were not present with mononuclear cell cultures stimulated with a T-cell general stimulatory agent or with purified monocytes not specifically stimulated. With endotoxin-stimulated monocytes under in vitro conditions, an increased supernatant was shown for TNF-alpha, but not IL-6. With serum from the different patients cultured with monocytes employed from a healthy control, no difference between the groups was shown in the IL-6 and TNF-alpha response to endotoxin stimulation. The differences in IL-1 beta and TNF-alpha, but not IL-6 levels were differentiated statistically from the smoking and alcohol histories of the patients. These findings suggest that the function of monocytes in general, and thus possibly all mononuclear phagocyte system cells in HNSCC patients, are altered.

Alcoholism↗
PubMed1999

A comprehensive analysis of selected diagnostic methods with respect to their usefulness in evaluating the biology of neoplastic cells in patients with laryngeal cancer.

The difficult and complicated mechanism of cancer development with little knowledge about the biology of existing cancers can lead to a permanent search for new examination techniques to improve the precision of life expectancy in patients and the selection of the most efficient methods of treatment. The aim of this study was to analyze certain prognostic factors, i.e., p53, Ki67, proliferating cell nuclear antigen (PCNA), DNA ploidy and cell proliferating activity, as well as the degree of morphological differentiation and cell maturity evaluated on an ultrastructural level in patients with laryngeal cancers in connection with data obtained from follow-up examinations and the clinical course of the disease. Neoplastic tissue was taken from 120 patients with laryngeal cancers. All underwent surgical treatment, radiotherapy and combined treatment in the Department of Otolaryngology. Karol Marcinkowski University School of Medical Sciences, Poznań, Poland, and the Department of Otolaryngology-Head and Neck Surgery, Haukeland University, Bergen, Norway. Before beginning treatment all patients underwent histological verification of their neoplastic tissues. Histopathological examination proved that the majority of cases (95%) had a squamous cell carcinoma. The occurrence of changes within the lymph nodes of the neck (N) was significantly correlated with T, S, Ki67, metastases to lymph nodes, DNA ploidy, site and surgery performed. The degree of clinical progression (S) was intercorrelated with T, N, p53, Ki67, PCNA, DNA ploidy, site and laryngectomy. The occurrence of oncoprotein p53 in neoplastic cells was measured by the staining degree of their nuclei and was correlated with T, S, DNA ploidy, metastases to lymph nodes, PCNA and site. The degree of staining of neoplastic cells for the nuclear antigen Ki67 was correlated to T, N, G, S, DNA ploidy, metastases to lymph nodes and surgical treatment. The proliferative antigen PCNA in the examined population of patients was intercorrelated with T, p53, Ki67, metastases to lymph nodes and surgical treatment. The results obtained from DNA flow cytometry could be associated with N, G, p53, Ki67 and metastases to lymph nodes. On the basis of the results obtained, the techniques suggested for the morphological and biological evaluation of neoplastic cells in cancer of the larynx should include TNM classification + G + DNA + p53 + Ki67.

Adult↗
PubMed1999

Elevated levels of human salivary epidermal growth factor after oral and juxtaoral surgery.

PURPOSE: Saliva provides a natural reservoir of growth factors whose purposes have remained elusive. Animal studies suggest that saliva-derived growth factors play a role in systemic and oral wound healing. In the current study, salivary concentrations of epidermal growth factor (EGF) were monitored in patients before and after oral and juxtaoral surgery. PATIENTS AND METHODS: Whole resting saliva was collected from a group of patients with parotid gland tumors requiring surgical resection. Another group of patients a history of periodontal disease requiring surgical intervention also provided whole salivary samples. Healthy age- and sex-matched persons served as controls. RESULTS: Salivary EGF levels were elevated in both groups of patients within 24 hours after surgery. In the periodontitis patients, a second smaller peak was assayed noted between 36 and 48 hours. After this, EGF concentrations returned to levels comparable to healthy controls in both experimental groups. CONCLUSIONS: Although the local cells have the ability to synthesize and secrete growth factors at a site of injury, these results suggest that surgery stimulates increased synthesis and secretion of growth factors in the saliva as well. This increased level of saliva-derived growth factor may also aid in promoting wound healing.

Adult↗
PubMed1999

Peripheral blood mononuclear cell (PBMC) responsiveness in patients with head and neck cancer in relation to tumour stage and prognosis.

We have previously shown an increased T lymphocyte and monocyte responsiveness in peripheral blood mononuclear cells (PBMC) from patients with head and neck squamous cell carcinoma (HNSCC) compared with PBMC from control patients. This study reports T lymphocyte function of PBMC of 81 patients with HNSCC dependent on disease stage and prognosis. Males with HNSCC under 80 years of age without cachexia, with no auto-immune disease or previous cancer and on no immuno-active medication were included at the time of diagnosis of disease. The follow-up was for at least 18 months. When cells from patients with early vs late stage disease according to the T, N or T + N stage of HNSCC were compared, decreased in vitro mitogen-stimulated and spontaneous T cell proliferation was seen with increasing tumour stage. When patients were studied according to disease-specific survival, a decreased T lymphocyte mitogen-stimulated proliferation was observed to be associated with a poorer prognosis. No changes in prognosis were noticed related to decreased gamma-IFN, IL-2 or IL-4 level of the supernatants of the T lymphocyte-stimulated PBMC in vitro cultures. With stratification for disease stage, we determined that PBMC in vitro T lymphocyte-stimulated proliferation predicted outcome for the HNSCC patients. The results were similar for both laryngeal and oral cavity/pharyngeal cancers. The present investigation provides evidence to support the idea that the relationship between HNSCC and the immune system of the host may provide clinically useful information about prognosis.

Carcinoma, Squamous Cell↗
PubMed1999

Competition for total mixed diets fed for ad libitum intake using one or four cows per feeding station.

When dairy cow facilities are being designed, a limited feeding area might be profitable and recommendable if the increased competition for feed does not harm the welfare of the animals or affect production negatively. An experiment was conducted at the University Cattle Research Centre (Uppsala, Sweden) to investigate the performance of individual cows as well as groups of cows. Treatments used 1 or 4 cows per feeding station with a total mixed diet fed for ad libitum intake. The feeding stations were troughs placed on electronic balances and were 1.08 m wide. Sixteen dairy cows were divided into two groups and were studied in an experiment with a change-over design so that each group went through each treatment twice. A computerized feeding system automatically recorded consumption data for feed and water. Video recordings were used to study the social dominance order, the level of aggression at the feeding area, and the time budget of the cows. The mean feed intake increased slightly, but the number of visits to the feeding stations did not change at the higher level of competition. The cows, however, spent significantly less time eating and increased their consumption rate when the competition level increased. The number of displacements at the feeding stations increased dramatically. Cows of low social rank were much more frequently displaced while eating. The effects of dominance value, age, eating rate, and energy requirement of the cows are presented.

Animal Feed↗
PubMed1998

Correlates of apoptosis of CD4+ and CD8+ T cells in tonsillar tissue in HIV type 1 infection.

The immunopathogenesis of human immunodeficiency virus type 1 (HIV-1) infection has been associated with increased death by apoptosis of T cell subsets. In the present study, we have examined correlates of apoptosis of CD4+, CD8S+CD28+, and CD8+CD28- T cells in tonsillar lymphoid tissue in persons with HIV-1. Single-cell suspensions of tonsillar lymphocytes were analyzed by flow cytometry to determine the fraction of cells showing typical characteristics of apoptosis as well as the expression of activation markers within the live and the apoptotic cell populations. The proportion of cells carrying infectious provirus was quantified by limiting dilution analysis. Compared with uninfected controls, apoptosis of both CD4+ and CD8+ T cells was enhanced in HIV-1 infection and was higher among CD8+ than among CD4+ T cells. Apoptosis of CD28-cells was more prevalent than apoptosis of CD28+ cells for both CD4+ and CD8+ T cells. Occurrence of apoptosis of CD4+ T cells correlated with provirus levels and proportional expression of the activation marker HLA-DR. Apoptosis of CD8+CD28+ cells correlated with expression of the activation markers CD69 and HLA-DR while apoptosis within CD8+CD28- cells did not correlate with any of the studied parameters. Although apoptosis was much more prevalent among CD8+ than CD4+ T cells, CD8+ T cells still accumulated in tonsillar lymphoid tissue in persons with HIV-1. Our data may be interpreted to suggest that apoptosis of CD4+, CD8+CD28+, and CD8+CD28- cells in tonsillar tissue is regulated by different mechanisms and the results are of importance to our understanding of the immunopathogenesis of HIV-1 infection.

Adult↗
PubMed1998

[Retrospective analysis of selected tumor markers (p53, PCNA, Ki67; DNA ploidy) and ultrastructure in patients with larynx carcinomas].

A comparison was made of the staining intensities of selected immunohistochemical proliferating antigens (p53, PCNA, Ki67), DNA flow-cytometry and ultrastructures of neoplastic cells from 120 cases of laryngeal cancers. Clinically very advanced tumors were in the majority (T3, 43%; T4, 18%). A 5-grade scale was adopted to evaluate the level of immunohistochemical staining of the carcinoma cell nuclei. Positive staining was obtained in 70% for p53, 57% for Ki67 and 80% for PCNA. Sixty-two percent of the cases were DNA-diploid and 38% DNA-aneuploid. The DNA-diploid carcinomas were accompanied by enlargement of the cell nuclei, preservation of wide margins of nuclear heterochromatin, enlargements of the nuclear areas and increases in the number of nuclei. In the aneuploid-polyploid cancers the nuclei had a substantial polymorphism, with large cleaved nuclei showing significant variations in size and having a nuclear envelope. A frequent finding was euchromatization of chromatin. Dense chromatin appeared in the form of small clumps spread over the whole area of these irregular nuclei. Enlargement and activation of nucleoli were found. There was a positive (chi-square) correlation between T- and N-stage and immunohistochemical staining. There was also a positive correlation in staining intensity between p53, Ki67 and PCNA markers and strong correlation between these markers for proliferative activity and the degree of aggressiveness of a tumor.

Biomarkers, Tumor↗
PubMed1998

Melanotic neuroectodermal tumour of infancy arising in the maxilla.

Melanotic neuroectodermal tumour of infancy is an uncommon neoplasm that usually occurs in children aged one year or less. Difficulty in deciding the cellular origin of this tumour has led to numerous names, including congenital melanocarcinoma, melanotic epithelial odontoma, melanotic ameloblastoma, and retinal anlage tumour. Electron microscopy and histochemical studies, however, have now established the neural crest origin. The most frequent site of occurrence is the maxilla followed by the skull, the brain and the mandible. The genital organs are the most frequent extracranial site. We present two cases of melanotic neuroectodermal tumour of infancy arising in the maxilla.

Humans↗
PubMed1998

Disease stage related in vitro responsiveness of peripheral blood T-lymphocytes in patients with head and neck carcinoma.

The in vitro responsiveness of peripheral blood mononuclear cells (PBMC) T lymphocytes was studied in 81 patients with limited or extended head and neck squamous cell carcinoma (HNSCC), as judged by T, N and T + N stages. Patients included in the study were males below 80 years of age, without auto-immune disease or cachexia, who were not taking any immuno-active medication at the time of diagnosis. The patients were divided into groups according to TNM stage T0-2 vs T3-4, N0-1 vs N2-3 or T + N0-3 vs T + N4-7. When cells from patients with early and late stage, according to T, N or T + N stage, were compared, we found a decreased level of mitogen stimulated T-cells and decreased spontaneous proliferation with increasing disease stage. The same was true if the in vitro mitogenesis of T-cells was analysed separately, depending on the laryngeal or oral cavity/pharyngeal origin of the patients' tumours. If the patients were divided into two groups based on N stage, decreased gamma-interferon, and to some extent interleukin (IL-2), but not IL-4 levels, were found to be related to the disease stage.

Aged↗
PubMed1998

Systemic and mucosal immune responses in young children and adults after parenteral influenza vaccination.

The effect of natural mucosal priming on systemic and mucosal immune responses was investigated in young children after parenteral influenza vaccination. Eighteen young children and 8 adults were vaccinated with trivalent influenza vaccine at various time intervals before tonsillectomy. The influenza-specific IgG, IgA, and IgM immune responses were examined in tonsillar lymphocytes and frequent samples of peripheral blood and oral fluid. Young children were divided into primed and unprimed groups on the basis of presence of prevaccination serum antibodies. In peripheral blood, adults and primed children had significantly higher IgG and IgA antibody responses than did unprimed children. Irrespective of priming, children elicited weaker IgA responses than adults in both tonsils and oral fluid. While natural priming was essential to elicit strong systemic response in young children after parenteral influenza vaccination, it did not influence the local responses, which were significantly lower in both primed and unprimed children than in adults.

Adult↗
PubMed1997

Correlates of latent and productive HIV type-1 infection in tonsillar CD4(+) T cells.

Correlates of virus load and characteristics of virus-producing cells in tonsillar tissue were investigated. Our results suggest that when less than 1:100 tonsillar CD4(+) T cells from individuals infected with HIV type-1 (HIV-1) contain replication competent provirus, the level of CD4(+) T cells in tonsils is comparable to that observed in uninfected individuals. Virus load at or above this level was associated with low CD4 cell numbers in tonsillar tissue. Only a few percent of all infected T cells in tonsillar tissue were active virus producers, with minor differences observed between individuals. Plasma viremia was found to correlate with infectious virus load in tonsillar tissue. With less than 1:1,000 of CD4 cells in lymphoid tissues being involved in active virus production, direct cytopathic effect by HIV-1 on infected CD4 cells is unlikely to fully explain the immunodeficiency seen in AIDS.

Adult↗
PubMed1997

Alteration of p53 gene structure and function in laryngeal squamous cell cancer.

The p53 gene is known as an anti-oncogene that manifests its function by controlling the cell cycle and is responsible for apoptosis of cells with unrepaired DNA. An accelerated p53 protein synthesis is the first response of a cell following DNA damage. However, mutations of the p53 gene can disturb protein synthesis or may be responsible for synthesis of a changed protein unable to control the cell cycle. Laryngeal tissue specimens from 120 patients were tested by immunohistopathological staining to detect mutated wild-type p53 protein. It was found that p53-positive specimens correlated with TNM staging and histopathological grading. Another indication of entering the cell cycle and undertaking an active proliferation by laryngeal cells was shown by detection of proliferating cell nuclear antigen (PCNA) and Ki67 nuclear antigen, which appeared in proliferating cells (late G1, S-G2 and M phase), but was absent in resting cells. Scoring of the staining for p53 protein, PCNA and Ki67 correlated with each other. DNA from 40 specimens was then isolated, amplified by polymerase chain reaction and analysed by single-strand conformation polymorphism and DNA sequencing for mutation in the p53 gene. Fifteen DNA samples were found to be positive, while mutations were detected in exons 5-8 in 13 samples. The majority of mutations were found in tissue specimens from T3 and T4 tumors. A possible explanation is almost half was attributable to genotoxic effects of tobacco smoking. Changes in the p53 gene and its products may also reflect early changes in laryngeal carcinogenesis and be of prognostic value.

Adult↗
PubMed1997

In vitro T-lymphocyte function in head and neck cancer patients.

T-lymphocyte cell function was studied in vitro in peripheral blood mononuclear cells (PBMC) from 61 male patients with head and neck squamous cell carcinomas compared to 46 control patients. Patients older than 80 years or with reduced tumor-related performance status as measured by Karnofsky score less than 75 were excluded. In contrast to previous similar studies, control subjects ensured a minimum stress load by sampling all patients on the day of either diagnostic or therapeutic surgery. PBMC were separated by density-gradient centrifugation and subsequently cultured with autologous sera in vitro. The mitogen concanavalin A (Con A), which stimulates all T-cell clones, was employed. Findings showed that increased Con A stimulation and PBMC proliferation occurred with PBMC from cancer patients compared to that from control patients. In contrast, no differences could be detected with respect to the stimulated supernatant level of interleukin-2, interleukin-4 or interferon-gamma between the groups. These results suggest that T-lymphocytes from PBMC are generally affected by neoplastic disease through either a supporting cell or serum factor.

Analysis of Variance↗
PubMed1997

[Significance of p53, PCNA and Ki-67 in the prognosis of squamous cell carcinoma of the oral cavity].

BACKGROUND: A common gene alteration in human malignancies is the mutation of the p53 gene. Through mutation p53 loses its function as a tumor suppressor and enables the tumor to proliferate. Ki-67 and PCNA are proliferation markers. The aim of this study was to find a reference to the prognostic significance of p53, Ki-67, and PCNA in squamous cell carcinoma (SCC) of the oral cavity. MATERIAL AND METHODS: Samples from 64 patients of the Department of Otolaryngology/Head and Neck Surgery, University of Bergen, Norway, with histologically proven SCC of the oral cavity were submitted to immunohistochemical procedure. All carcinomas were untreated. RESULTS: 59.3% of the patients showed a positive reaction for p53.Ki-67 and PCNA were expressed in about 68% of the cases, but with less staining intensity. No correlation could be found between the expression of the three antibodies and tumor factors such as tumor size, lymph nodes, degree of differentiation, recurrence and survival rate, the occurrence of second primaries, or the smoking habits of the patient. CONCLUSIONS: The expression of the tumor suppressor gene p53 and the proliferation marker PCNA and Ki-67 seem to have no prognostic significance in SCC of the oral cavity.

Adult↗
PubMed1997

Barrier between the supraglottis and the glottis: myth or reality?

Controversial opinions on the existence of a "barrier" between the supraglottic and glottic regions of the larynx are reported. Even if the two areas have different embryological derivations, there is no anatomic evidence of a "barrier" that could prevent supraglottic cancer from extending downward to the glottis. Numerous adequate pathologic studies, including whole organ sections, confirm that for advanced cancers, anatomic compartments delimiting the spread of the neoplastic process from the supraglottis to the glottis do not exist. Therefore, supraglottic laryngectomy should be performed not on the basis of embryological considerations, but on the basis of the actual extension of the neoplastic lesion.

Glottis↗