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L Karlberg

Publications and source records attributed to L Karlberg.

At least 19 recordsLinked to original sources
PubMed2002

Prognostic value of the Gleason score in prostate cancer.

OBJECTIVE: To investigate the prognostic value of the Gleason score in prostate cancer. PATIENTS AND METHODS: A consecutive series of 305 men with prostate cancer diagnosed at transurethral resection (1975-1990) and with no curative treatment was analysed. There was no assessment of prostate-specific antigen level during this period. The mean (range) age at diagnosis was 73.7 (52-95) years and the mean follow-up was 6.4 (0-22) years. The influence of Gleason score and the percentage of the specimen area with tumour (% cancer) on disease-specific survival were assessed using Kaplan-Meier analyses. RESULTS: Of 305 cancers, 22% had a Gleason score of 4-5, 29% of 6, 18% of 7 and 32% of 8-10. At the follow-up, 89% of the men had died, of whom 42% had died from prostate cancer. The disease-specific 10-year survival was 56%. The disease-specific mean survival (DSMS) for Gleason score 4-5, 6, 7 and 8-10 was 20, 16, 10 and 5 years, respectively (P < 0.001). The DSMS did not differ significantly between Gleason 4 and 5 or between 8-10. There was a trend towards shorter survival for Gleason 4 + 3=7 (DSMS 9 years) than GS 3 + 4=7 (DSMS 13 years; P = 0.16). Gleason score and % cancer were independent predictors of DSMS (P < 0.001). CONCLUSION: The long-term prognosis of prostate cancer on deferred treatment is predicted well by the Gleason score. Four prognostic categories of prostate cancer are suggested, i.e. Gleason score 4-5, 6, 7 and 8-10.

Aged↗
PubMed2000

[The good talk].

Explore the source record for details and available documents.

Communication↗
PubMed1998

Type A behavior intervention in primary health care reduces hostility and time pressure: a study in Sweden.

This study evaluates the effects of an intervention on hostility and time pressure in primary health care patients. A total of 47 men and women were studied, of whom 22 participated in an intervention program and 25 were controls. The intervention group changed global Type A behavior, hostility and time pressure significantly more than the control group and this change was stable up to 2 years following the study. Men altered their behavior significantly more than women.

Adult↗
PubMed1998

Is there a connection between car accidents, near accidents, and type A drivers?

The authors examined Type A behavior pattern, which has been investigated primarily as a risk factor for coronary heart disease, as a risk factor for car accidents and near accidents. Type A behavior pattern, which is characterized by excessive impatience, competitiveness, hostility, and time pressure, was assessed by means of the Videotaped Structured Interview. One hundred thirty-five Swedish car drivers (66 men and 69 women) were studied: 78 Type A and 58 Type B (that is, not having, Type A behavior). Time pressure was significantly associated with near accidents when age, sex, annual mileage, and urban driving were controlled in a multivariate model.

Accidents, Traffic↗
PubMed1997

Psychometric properties of a brief self-report Type A questionnaire for use in primary health care.

OBJECTIVE: To develop a short and easily used self-report measure of Type A behaviour (Simplified Type A Questionnaire = STAQ) and to examine its capacity to predict Type A behaviour as assessed by more time-consuming measures. DESIGN: A Videotaped Structured Interview (VSI) and a self-report measure, previously validated in Sweden, were used as comparison instruments to the STAQ. SETTING: Primary health care. PATIENTS: 206 (81 men and 125 women) aged 17-75 years attending a health centre during one year. MAIN OUTCOME MEASURES: The reliability, measured by Cronbach's alpha and split-half correlation. The specificity and sensitivity of the STAQ. The correlaiton between the STAQ and the two other diagnostic measures. RESULTS: The reliability of the STAQ was 0.70 and 0.75, respectively. The specificity was 83% and the sensitivity 75%. The correlation between the STAQ and the VSI was 0.45. The correlation between the STAQ and the previously validated self-report was 0.61. CONCLUSIONS: The STAQ has good psychometric properties and, in comparison with other diagnostic measurement instruments in medical service, it has an acceptable discrimination capacity.

Adolescent↗
PubMed1997

Cell proliferation assessed by Ki-67 immunoreactivity on formalin fixed tissues is a predictive factor for survival in prostate cancer.

PURPOSE: Proliferation rate may be an important determinant of tumor progression. To evaluate the predictive value of proliferation, immunoreactivity for the proliferation associated antigen Ki-67 was related to survival in a series of patients with prostate cancer. MATERIALS AND METHODS: Formalin fixed tissue, obtained by transurethral resection from 125 previously untreated prostate tumors, was examined with an immunohistochemical method for Ki-67. Ki-67 index was defined as the percentage of immunoreactive cells in a tumor. Patients were followed with surveillance after transurethral resection. The cause of death was determined by examination of patient records 11 to 19 years postoperatively (mean followup 71 months). At evaluation 17 patients (14%) were still at risk and 55 (44%) had died of prostate cancer. RESULTS: Mean Ki-67 index was 2.1. Ki-67 index correlated with grade (p < 0.0005) and weakly with stage (p = 0.019). Mean survival of patients with a Ki-67 index of more than 3 was less than half that of patients with a Ki-67 index of less than 3 (53 versus 132 months, p < 0.00005). The difference in survival remained in an analysis of the intermediately differentiated tumors (61 versus 126 months, p = 0.0032). In a Cox multiple regression analysis for cancer specific survival, including Ki-67 index, grade, stage, metastasis and age, Ki-67 index remained an independent predictive factor. CONCLUSIONS: Our study indicates that proliferation rate, assessed by Ki-67 immunoreactivity in formalin fixed tissues, is a predictive marker for outcome in prostate cancer.

Aged↗
PubMed1997

Long-term outcome of conservative therapy in men presenting with voiding symptoms and prostate cancer.

OBJECTIVE: To investigate the outcome of conservative therapy in men presenting with voiding symptoms and prostate cancer. METHODS: A consecutive series of 186 men presenting with voiding symptoms and prostate cancer were treated with transurethral resection (TUR). Examination of the resected tissue revealed 70 nonpalpable prostate cancers and confirmed the clinical suspicion of prostate cancer in 116 palpable tumors; 47 tumors were well differentiated, 87 intermediate and 52 poorly differentiated. Bone scan indicated metastasis in 24 men, all asymptomatic. The men were followed and underwent orchidectomy if symptoms of generalized disease appeared. RESULTS: After a follow-up of 13-21 years, 172/186 (92%) of the men had died, with 80/186 (43%) of the men dying of prostate cancer. The mean life expectancy was 6.3 years (confidence interval 5.4-7.1) compared with 10.2 years of an age-matched control group. In a subgroup of men with clinically localized disease, 26/97 (27%) died of prostate cancer. These men had a mean life expectancy of 7.1 years (confidence interval 6.0-8.3). Tumor stage and grade were highly significant predictors for cause-specific survival in uni- and multivariate analysis. Death from prostate cancer continued to occur beyond 10 years after diagnosis at a decreasing rate. CONCLUSIONS: Patients with prostate cancer causing voiding symptoms at presentation severe enough to necessitate TUR had a less favorable outcome than asymptomatic patients with prostate cancer in previously reported series, even when stratified for stage and grade. It is suggested that voiding symptoms at diagnosis are a putative prognostic factor in prostate cancer.

Age Factors↗
PubMed1996

Bcl-2 immunoreactivity in prostate tumorigenesis in relation to prostatic intraepithelial neoplasia, grade, hormonal status, metastatic growth and survival.

The Bcl-2 protein prolongs cell survival by overriding apoptosis. To explore the role of Bcl-2 in prostate tumorigenesis, immunoreactivity for Bcl-2 was examined in untreated and androgen-deprived tumours and lymph node metastasis. Following the transurethral resection, 150 untreated patients were maintained under surveillance until death or for a minimum of 11 years, and castration was performed at symptomatic progression. The Bcl-2 index (BI) was defined as the percentage of immunoreactive cells in a tumour. The mean BI was 12 in the untreated tumours, and BI was significantly higher in high-grade tumours, mean BI 17, than in low-grade tumours, mean BI 6. There was no correlation between BI and stage or metastatic disease, nor did BI predict cancer-specific survival. In 16 androgen-deprived, but non-relapsed tumours, the mean BI was 54, at a mean time of 22 months after castration, indicating a permanent increase of Bcl-2 protein expression after androgen withdrawal. In six patients, tissues from the prostate tumour and obturator lymph node metastasis were available. Four primary tumours immunostained for Bcl-2, but only one metastasis stained. Foci of highgrade prostatic intraepithelial neoplasia (PIN) were present in 44 of the 150 untreated tumours. All PIN foci were intensely immunoreactive for Bcl-2, and mean BI was 79, suggesting that Bcl-2 protein expression is associated with early prostate tumorigenesis.

Aged↗
PubMed1996

p53 immunoreactivity as prognostic marker for cancer-specific survival in prostate cancer.

OBJECTIVES: The objective of this study was to evaluate the role of p53 immunoreactivity as a prognostic marker in prostate cancer. METHODS: The nuclear accumulation of the aberrant p53 protein was determined by immunohisto-chemistry on surgical specimens and related to stage, grade and cancer-specific survival in 186 prostate cancer patients treated with transurethral resection and subsequent surveillance. RESULTS: There was a significant correlation between p53 staining and grade: 2% of the highly differentiated, 8% of intermediately, and 21% of the poorly differentiated tumors stained. Patients with p53-positive tumors had a significantly shorter survival (52 months) than the p53-negative group (123 months). However, in a Cox multiple regression analysis of p53 status, tumor stage, grade, metastasis and age, p53 lost its significance as an independent predictor. CONCLUSIONS: p53 is a rare and late event in prostate cancer, indicating that other molecular mechanisms may be of greater importance in the development of prostate cancer. The predictive value of p53 apparently depends on its association with high grade and advanced stage, and it is not a useful prognostic marker in prostate cancer. However, p53 status could play a role in the evaluation of patients prior to radiotherapy since p53 inactivation may produce radioresistant tumors.

Adult↗
PubMed1996

Long-term outcome of patients treated for hydrocele with the sclerosant agent sodium tetradecyl sulphate.

The long-term outcome of 106 patients treated for hydrocele with the sclerosing agent sodium tetradecyl sulphate was examined. In a questionnaire distributed at a mean time of 40 months after therapy 83/86 (96%) of the eligible patients responded and 95% of them were satisfied with the treatment and its long term results. The treatment associated pain was evaluated on a visual analogue scale (0-10) the mean pain score was found to be 1.8 and the mean duration of the pain 2.4 days. When all hydroceles were considered the overall success rate was 88%. Side-effects were minor apart from two patients (1.9%) with diabetes mellitus who had an intense inflammatory reaction necessitating orchidectomy after sclerotherapy.

Adolescent↗
PubMed1991

Modal DNA values and estramustine-binding protein (EMBP) as prognostic markers in prostatic cancer.

In this study, we have investigated the model DNA values and the expression of estramustine-binding protein (EMBP) in formalin-fixed and paraffin-embedded TUR specimens from 76 untreated patients with prostatic cancer. In addition, specimens from 13 patients were analyzed for tumour EMBP expression only. Ploidy was measured as diploid, tetraploid and non-tetraploid aneuploid or aneuploid in the near-diploid region. All patients had been referred during 1978-1981, and were subjected to TUR due to urinary obstruction. Survival data were obtained for all patients through March 1988. Statistical analyses were performed using a Cox's regression model with respect to survival and cause specific survival and correlated to the DNA pattern and the expression of EMBP. The existence of a near-diploid aneuploid cell population as well as poor differentiation grade were both statistically significantly correlated with poor survival. Near-diploid aneuploid cell lines were seen in 9/76 (12%) of the patients and were also seen in well differentiated cancers (4/17). The expression of EMBP was most abundant in the moderately differentiated cancers. However, all prostatic cancer specimens investigated were positive for the antigen. Patients with poorly differentiated carcinomas and high EMBP expression showed a tendency towards better prognosis than those with poorly differentiated carcinomas and low EMBP expression. The present patient material was, however, too small to show a statistically significant correlation between EMBP and survival.

Aged↗
PubMed1988

Expression of estramustine-binding protein (EMBP) and the proliferation-associated antigen Ki-67 in prostatic carcinomas.

The expression of EMBP and the proliferation-associated antigen Ki-67 was studied in in vitro cultured prostatic carcinoma cells and in tumor tissues removed by transurethral electroresection (TUR). EMBP was found to be expressed predominantly in the moderately differentiated carcinomas. A technique based on the immunohistochemical analysis of fine needle specimens was also evaluated. This technique is of potential interest in prospective studies and in monitoring the effect of therapy. Ki-67 was found to be expressed in the prostatic carcinoma cell line (DU-145) studied, as well as in TUR specimens. This antigen reflects the proliferative characteristics of the tumor and may prove useful with respect to prognostic information and choice of appropriate therapy.

Antibodies, Monoclonal↗
PubMed1985

Renal vasodilation after unilateral renal ablation.

Renal blood flow was studied in rats 120 minutes after unilateral renal ablation. The influence of endogenous prostaglandin formation was evaluated by indomethacin treatment prior to the ablation. Radioactive microspheres were used for estimation of the total renal and cortical blood flow, and the renal medullary blood flow was determined with the 86-Rb chloride extraction method. The total blood flow in the remaining kidney was increased by 80% following contralateral ablation, with augmentation in all areas, particularly in the deep medullary region. Indomethacin treatment in intact rats evoked increased blood flow as compared with the indomethacin control group. The results indicated that the renal blood vessels respond to ablation of the contralateral kidney with dilation in all kidney regions, and that this vascular dilation may be prostaglandin-mediated.

Animals↗
PubMed1984

Total and regional renal blood flow during complete unilateral ureteral obstruction.

Regional renal blood flow was investigated after 1, 2, 12 and 24 h of unilateral ureteral obstruction in rats. Total renal and cortical blood flow rates were determined by the microsphere technique and regional medullary blood flow by the 86-Rb extraction method. The kidneys were microdissected into cortex and medulla, which was further divided into the outer stripe and the inner stripe of the outer zone, and the inner zone. In the obstructed kidneys cortical blood flow increased by 33% after 1 h of obstruction, but was normalized after 2 h. After 12 and 24 h this flow was significantly decreased (55% and 65% of control respectively). The pattern of total renal blood flow was similar to that of cortical blood flow. In the outer stripe there was an initial increase (44%) after 1 h, but later no significant deviations from control values were found. After 1 h of obstruction the blood flows in the inner stripe and the inner zone were not significantly different from control values. A significantly decreased blood flow was seen in the inner stripe after 2 h (57% of control) and in the inner zone after 12 h (58% of control). A significant recovery of the blood flow had occurred in the inner stripe and the inner zone after 24 h of obstruction. In the contralateral, non-obstructed kidney no significant changes were found, besides an increased innerstripe blood flow after 24 h of UUO.

Animals↗
PubMed1983

Impaired medullary circulation in postischemic acute renal failure.

Acute renal failure was induced in heparinized rats by clamping the renal artery for 45 min. Ten minutes after recirculation the intrarenal blood flow distribution was measured. For this purpose labelled microspheres were injected together with 86-Rb chloride. The microspheres were used for determination of cardiac output, total renal and cortical blood flow, and 86-Rb for calculations of medullary blood flow. Total renal blood flow was reduced from 7.6 to 3.8 ml . min-1 . g-1 and cortical blood flow was reduced from 11.7 to 7.0 ml . min-1 . g-1. In the outer stripe of the medulla there was a reduction from 2.5 to 1.4 ml . min-1 . g-1. In the inner stripe there was a more pronounced reduction from 1.8 to 0.2 ml . min-1 . g-1 and in the inner zone from 0.8 to 0.1 ml . min-1 . g-1. The marked reduction in the blood flow to the renal medulla after recirculation is suggestive for a medullary ischemia, which might be responsible for the characteristic dysfunctions in acute renal failure.

Acute Kidney Injury↗
PubMed1982

Postischemic renal failure. Intrarenal blood flow and functional characteristics in the recovery phase.

Intrarenal blood flow, nephron function and whole kidney function were studied in the recovery phase of acute failure induced by 45 min of warm ischemia. Analyses were made 24 h, 7 days and 28 days after the ischemic insult. At 24 h the total renal blood flow was 4.0 ml . min-1 . g-1, decreasing to 1.2 within one week. After four weeks it was normalized to 3.4 ml . min-1 . g-1. The intrarenal blood flow distribution, studied with the 86-Rb extraction method, showed the same pattern of response, with no signs of a persistent heavy reduction in the deeper parts, as was found 10 min after recirculation (Karlberg et al. 1982 a). The contralateral, nonischemic kidney responded with hyperemia in all areas 24 h after the trauma, but after 7 days the values were normal. The function of the superficial nephrons was studied with the micropuncture technique. In the initial phase mainly obstructed nephrons were found, but after four weeks the nephrons were essentially normal. After 24 h the postischemic kidneys were anuric but at 7 days urine production had started and the GFR was 0.1 ml . min-1; this improved to 0.55 ml . min-1 after 4 weeks.

Acute Kidney Injury↗