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Biomedical subjects

M Carlsson

Publications and source records attributed to M Carlsson.

At least 91 records · Page 5Linked to original sources
PubMed1996

Swedish Health care personnel's perceptions of disease and treatment-related problems experienced by children with cancer and their families.

In recent decades, the intensification of treatment of children with cancer has resulted in a considerable increase in the number of those cured. The intensive treatment has also led to several problems for the children and their families. The aim of the present study was to identify the physical, psychological, social, and existential problems; symptoms and inconvenience caused by the disease and treatment or the hospital stay determined by Swedish health care personnel to be the most troublesome for children with cancer and their families. A modified three-round Delphi technique was used. In this way, 207 different problems were identified by 24 health care personnel. According to the personnel, the child is most troubled by physical symptoms, and family members are most troubled by feelings of anxiety about future events or possible events. The personnel interpreted the family members' problems as significantly worse than the child's. The results are related to the age and the diagnosis of the child.

Adult↗
PubMed1996

Polymorphism at the rad gene is not associated with NIDDM in Finns.

Recently, a trinucleotide repeat polymorphism at the rad (ras associated with diabetes) locus (RAD1) on chromosome 16q was described in association with NIDDM in white Americans. In an attempt to replicate this finding, we screened RAD1 and another microsatellite marker at the D16S265 loci, which is located near the rad locus, with a radioactive polymerase chain reaction method in 290 unrelated Finnish NIDDM patients and 270 control subjects and related the findings to measures of insulin sensitivity. Both groups were randomly selected from the western (189 NIDDM patients and 184 control subjects) and southern (101 NIDDM and 86 control subjects) parts of Finland. The allele frequency distributions of RAD1 and D16S265 did not differ between NIDDM patients and control subjects in the studied population groups. The genotype distribution was also analyzed by structural classes of the RAD1 polymorphism, and no difference was detected between the NIDDM and control groups. In addition, carriers of allele classes I, II, and IV (reported to be preferentially associated with NIDDM in white Americans) did not differ from the class III homozygotes with respect to age at onset of NIDDM, BMI, or rates of insulin-stimulated glucose disposal. In conclusion, we found no association between the rad locus and NIDDM or insulin resistance in Finnish NIDDM patients.

Age of Onset↗
PubMed1996

A design for a World Wide Web decision-support system using a controlled medical terminology.

We have developed a medical decision-support system based on Arden Syntax for Medical Logic Modules and hypertext using the World Wide Web. The two representations are integrated to provide a better platform for decision support. To manage the integration a controlled medical terminology has been used as a well-defined interface between the representations. The terminology is also used to facilitate communication between specialists and non-specialists.

Artificial Intelligence↗
PubMed1995

An epidemiologic study of Lyme disease in southern Sweden.

BACKGROUND: Lyme disease is the most common vector-borne infection in some temperate regions of the Northern Hemisphere. However, for most areas of endemic disease reliable epidemiologic data are sparse. METHODS: Over a one-year period, we conducted a prospective, population-based survey of cases of Lyme disease in southern Sweden. The diagnosis was made on the basis of the presence of erythema migrans at least 5 cm in diameter or characteristic clinical manifestations such as arthritis, neuroborreliosis, and carditis. RESULTS: We identified 1471 patients with Lyme disease, for an overall annual incidence of 69 cases per 100,000 inhabitants. The incidence varied markedly according to geographic region, and there were several areas where disease was widely prevalent. The incidence varied according to age, with the highest rates among people 5 to 9 and 60 to 74 years of age, but not according to sex. The most frequent clinical manifestation was erythema migrans (seen in 77 percent of all cases), followed by neuroborreliosis (16 percent) and arthritis (7 percent). Carditis was rare. A preceding tick bite was reported by 79 percent of the patients. Bites in the head and neck region were more common among children than among adults and were associated with an increased risk of neuroborreliosis. CONCLUSIONS: Lyme disease is very common in southern Sweden, with a relatively high frequency of neurologic complications and arthritis. With the exception of the low incidence of carditis, the pattern of disease we found in Sweden was similar to that reported in the United States.

Adolescent↗
PubMed1995

A CD4+ T cell line-secreted factor, growth promoting for normal and leukemic B cells, identified as thioredoxin.

In this study, a B cell growth stimulatory factor, constitutively secreted by a human CD4+ T cell hybridoma clone, MP6, has been purified and characterized. Serum-free 24 h culture media from MP6 cells were collected, concentrated by ultrafiltration and separated by gel chromatography. Fractions were analyzed for stimulatory activity using [3H]thymidine incorporation in normal and leukemic (B-CLL) B cells as target cells. Activity was present in a 12 kDa protein peak. Upon storage this lost activity indicating that the factor was sensitive to air oxidation, a well-known property of mammalian thioredoxins (Trxs). Treatment of the inactive fraction with dithiothreitol restored full activity. When culture medium was analyzed with a radioimmunoassay for human placenta Trx, the MP6 clone was shown to release 30-50 ng/ml per million cells during 24 h. The B cell stimulatory activity of the MP6 medium was removed by Sepharose-bound anti-human placenta Trx IgG and activity was recovered by elution from the antibodies. Furthermore, MP6 medium showed Trx activity with NADPH and Trx reductase using an insulin disulfide reduction assay. Starting from 5 l of serum-free MP6 conditioned medium, the Trx was purified approximately 100,000-fold. After gel electrophoresis banding, the material was analyzed by peptide sequencing and a full length sequence of an 104 amino acid long protein was obtained. This Trx sequence was identical to the previously published sequence of human Trx from HTLV-1 transformed T cells, adult T cell leukemia-derived factor/Trx.(ABSTRACT TRUNCATED AT 250 WORDS)

Amino Acid Sequence↗
PubMed1995

Incidence of myelodysplastic syndromes in a Swedish population.

The myelodysplastic syndromes (MDS) have attracted great interest during the last decade. Unfortunately there is not much material published concerning the incidence of these conditions. We present epidemiologic data on MDS based on case registration of patients in a well-defined population and as a comparison similar data on acute myeloid leukaemia (AML). Between the years 1978-1992 we registered 120 cases of MDS and 146 cases of AML. The median age for all the MDS cases was 74.1 years for men and 78.2 years for women. Among haematologists there is a suspicion that the incidence of MDS is rising. Our study does not support this opinion. We have divided the study period into 5-year periods and the crude incidence has been 3.2, 4.1 and 3.5/100,000/year for each period. In the age group over 70 years MDS was more frequent than AML and in the last 5-year period the incidence was 15.0/100,000/year for MDS compared to 10.2/100,000/year for AML. In conclusion MDS is quite common among elderly people and there is no evidence for a rising incidence during the last 15 years.

Acute Disease↗
PubMed1995

Ampicillin plus mecillinam vs. cefotaxime/cefadroxil treatment of patients with severe pneumonia or pyelonephritis: a double-blind multicentre study evaluated by intention-to-treat analysis.

In this double-blind multicentre study, using the intention-to-treat approach, a total of 293 patients with fever (> or = 38.5 degrees C), symptoms of sepsis and signs of pneumonia or pyelonephritis were randomly assigned to treatment with ampicillin and mecillinam (A+M) or cefotaxime followed by cefadroxil. In the febrile phase, treatment was given intravenously twice daily, either with 1,200 mg ampicillin together with 600 mg mecillinam or with 2 g cefotaxime alone. When the patients stayed afebrile, the intravenous administration was replaced by oral treatment twice daily for 14 days, either with 500 mg pivampicillin and 400 mg pivmecillinam or 1 g cefadroxil. In the A+M group, 33% (48/144) of the patients did not complete the full course of treatment as compared with 32% (47/149) in the cephalosporin group, the reasons being treatment failure in 27 and 29, respectively, or adverse effects (n = 16 in both groups). The median duration of fever was 47 h in the A + M group and 50 h in the cephalosporin group. Of 135 patients with pneumonia, 68% were completely cured in the A + M group, and 65% in the cephalosporin group, the main reasons for treatment failure being Mycoplasma pneumonia or ornithosis. Of 136 patients with pyelonephritis, 63% were cured in each group. The main reason for failure was bacteriological relapse. Side-effects were reported by 32 patients (22%) of the A+M group, as compared with 41 (28%) of the cephalosporin group. Epigastric complaints were equally frequent in both groups, but there was a tendency for a higher frequency of exanthema in the A+M group, and for antibiotic-associated diarrhoea and fungal superinfections in the cephalosporin group.

Amdinocillin↗
PubMed1995

Analysis of some operating parameters of novel adsorbents for recovery of proteins in expanded beds.

We have analysed some operational parameters for two novel adsorbents intended for recovery of proteins from particle-containing feedstocks using expanded bed adsorption. The adsorbents tested were STREAMLINE DEAE and STREAMLINE SP, ion exchangers based on an agarose/crystalline quartz composite. Parameters analysed included bed expansion, adsorption efficiency, washing and elution. Bed expansion was considerably lower for STREAMLINE adsorbents compared to conventional agarose based media, higher flow velocities were thus possible during the expanded bed process. Breakthrough capacity was 63 mg ml-1 for lysozyme on STREAMLINE SP and 36 mg ml-1 for bovine serum albumin on STREAMLINE DEAE at a flow velocity of 300 cm h-1. To achieve high breakthrough capacity, the sedimented bed height should be at least 10 cm. Furthermore, breakthrough capacity increased to some extent when temperature was increased from room temperature to 36 degrees C, a phenomenon which can be useful in some processes. The number of living E. coli cells in the effluent was reduced by a factor of 10(5) after washing with 15 sedimented bed volumes. The optimal flow velocity for elution was 100 cm h-1 considering time for elution and volume of the eluted fraction. Flow direction during elution in packed bed mode had little impact on the elution volume, however, elution in expanded bed mode increased the volume by approx. 40%. The data presented on the performance of STREAMLINE adsorbents show that they are very useful for recovery of proteins from particle-containing feedstocks using expanded bed adsorption.

Adsorption↗
PubMed1995

Arden syntax and GALEN terminology support: a powerful combination to represent medical knowledge.

Arden syntax is an ASTM standard defined a few years ago to represent rule-based knowledge in the medical domain in an application- and implementation-independent way. Knowledge is expressed as Medical Logic Modules (MLMs). So far, it has mainly been used for providing critique and reminders in data driven, medical decision support systems, where typically rules are evoked by certain database operations (e.g., "store systolic blood pressure"). The syntax is an important step towards a general medical knowledge representation, with version control, maintenance information, arithmetic operations, logic rule syntax, and temporal operations, but it is not yet complete. The standard does not define how medical concepts (e.g., "systolic blood pressure") are to be referenced. Existing coding schemes such as SNOMED and ICD10 may be used for this, but they have generally failed to provide the required level of detail. The use of Arden syntax to transfer knowledge between centers in the form of MLMs has been shown to be non-trivial [1,2]. GALEN (Generalized Architecture for Languages, Encyclopedias, and Nomenclatures in Medicine) is an EC AIM project aiming at a machine-readable system to represent medical concepts in a semantic network. The network allows for the combination and specialization of concepts to the required level of detail. The project has resulted in a notation (GRAIL: GALEN Representation and Integration Language) and several tools, such as browsers for manipulating medical concepts. In a GALEN subproject, we are exploring the potential utility of combining Arden syntax with semantics from the GALEN terminology, and we are developing tools to facilitate the creation of MLMs with terminology support. Our impression is that the combination is very useful: GALEN tools allow a domain expert to express her knowledge in purely medical terms, independent of an actual or intended patient database structure and data representation. They can also help a knowledge engineer or quite possibly an automatic interpreter to translate a well defined medical concept (expressed in GRAIL) to actual database queries (in SQL or other notation). This translation can be facilitated by a Data Dictionary describing the local patient database.

Expert Systems↗
PubMed1994

Different induction mechanisms of mRNA for inducible nitric oxide synthase in rat smooth muscle cells in culture and in aortic strips.

The expression of mRNA for the inducible form of nitric oxide synthase, (iNOS), was studied in rat aortic smooth muscle cells, (SMCs) in cell culture and in strips of rat aorta by reverse transcriptase coupled to the polymerase chain reaction. iNOS mRNA expression was weak in cultured SMCs when exposed to either interferon-gamma (IFN gamma) or lipopolysaccharide (LPS), but the combination LPS+IFN gamma enhanced the expression. In aortic strips LPS alone induced a pronounced expression, with no further increase by IFN gamma. Cycloheximide potentiated the expression of iNOS mRNA in SMCs in culture stimulated with LPS+IFN gamma but attenuated the response in aortic strips. The results indicate different cellular signaling pathways for the induction of iNOS mRNA by LPS and/or IFN gamma, in cultured SMCs and in rat aortic strips.

Amino Acid Oxidoreductases↗
PubMed1994

Pharmacokinetics of factor IX in patients with haemophilia B. Methodological aspects and physiological interpretation.

The aims of this study were to investigate the influence of total blood sampling time on the estimated pharmacokinetic parameters of Factor IX procoagulant activity (FIX:C) and to relate the pharmacokinetics of FIX:C to the putative physiological disposition of Factor IX (FIX). Six patients with severe haemophilia B each received 2 infusions of FIX and on both occasions blood samples were collected for 104 h. Each FIX:C decay curve was processed with successive deletion of the last (remaining) datapoint. The fitted terminal half-life (t1/2 beta) and the calculated model-independent mean residence time (MRTMI), elimination clearance (CLMI) and volume of distribution at steady state (Vss) stabilised close to their final values when FIX:C data corresponding to at least 56 h of sampling were used. The final mean values were t1/2 beta = 34 h, MRTMI = 37 h, CLMI = 4.0 ml.h-1.kg-1 and Vss = 0.15 l.kg-1. The disposition of FIX could be characterised by a two-compartment pharmacokinetic model. On average, FIX molecules spent 44% of their total MRT in the second (or "extravascular") compartment. The distribution clearance was comparable to estimated total lymph flow. The volume of the central compartment was twice the estimated plasma volume, which may reflect the rapid and reversible binding of FIX to vascular endothelium. This explains the common clinical finding that the peak activity of FIX:C is less than the injected dose divided by the estimated plasma volume of the patient.

Blood Specimen Collection↗
PubMed1994

Psychological and psychosocial aspects of breast cancer and breast cancer treatment. A literature review.

The aim of the investigation was to study psychological and psychosocial aspects of breast cancer. A literature search was done covering the period 1989-1992. The following research areas were studied: the relationship between psychological characteristics and breast cancer, and between psychosocial interventions and breast cancer; quality of life after breast cancer surgery and treatment; and the relationship between social support and breast cancer. The results showed that the medical community is divided into "believers" and "nonbelievers" with respect to whether or not psychosocial factors influence breast cancer outcomes. One of the best predictors of a women's postcancer adjustment is her psychological state before the breast cancer. The results also showed that the difference in psychological outcome between mastectomy and breast-conserving surgery was small and nonsignificant. Another finding was that the social context and social support from partner, family, friends, relatives and medical professions are important for survival. In conclusion, methodological problems were common in studying psychological and psychosocial aspects of breast cancer.

Breast Neoplasms↗
PubMed1994

Epstein-Barr virus (EBV) can immortalize B-cll cells activated by cytokines.

B-type of chronic lymphocytic leukemia (B-CLL) cells are inert to the potent transforming action of Epstein-Barr virus (EBV). The mitogenic action of Staphylococcus aureus Cowan I (SAC), MP6-thioredoxin, and interleukin 2 (IL-2), agents previously shown to induce proliferation in normal as well as in B-CLL cells, lifted this block, and EBV-positive cell lines could be established. It was not possible to establish cell lines of leukemic origin from cultures that were incubated with EBV alone or cytokine mix alone. CLL-cells infected with EBV only, expressed the viral nuclear antigen complex (EBNA), but not the viral latent membrane protein (LMP). They were not activated as measured by cell size and 3H-thymidine incorporation. In contrast, cells incubated with EBV and cytokine mix expressed both EBNA and LMP in parallel with enlargement and increased 3H-thymidine incorporation. These results emphasize that LMP expression is a prerequisite for growth transformation and immortalization and that cytokine activation signals are required for its expression in B-CLLs. Cells incubated with SAC/MP6-thioredoxin/IL-2 did not express any of the viral antigens, but were activated with regard to the mentioned parameters. Nine cell lines were established from six patients. From each of the three patients, we obtained 'twin'-pair lines: one corresponding to the malignant cell and the other to a normal B-lymphoblastoid cell. Thus, malignant and normal B-cell counterparts, from the very same donor, are at hand for comparative studies. The cell lines have been carried out for more than 12 months in culture. We conclude that B-CLL that are refractory to EBV-transformation can be rendered susceptible through in vitro cytokine activation.

Antigens, CD↗