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Biomedical subjects

M Lindberg

Publications and source records attributed to M Lindberg.

At least 55 records · Page 3Linked to original sources

Elemental changes in skin from patients with basal cell carcinoma.

Intracellular ionic shifts have been described in connection with normal and abnormal cell proliferation. This study was conducted to determine the elemental composition of a cell tumor classified as basal cell carcinoma in skin. The biopsies were taken from 10 patients. Control biopsies were taken from the non-affected skin from the same patients. Cryosections were cut and attached to carbon specimen holders. After freeze drying the sections were analyzed by X-ray microanalysis in a scanning microscope. The X-ray microanalytical results showed that the content of magnesium, phosphorus and potassium was significantly higher in the cancer cells than in the control cells (p < 0.05). The content of sodium, chlorine, calcium and sulfur was similar in both affected and unaffected cells. We conclude from these data that basal cell carcinoma has a characteristic elemental composition. It is possible that increased potassium and magnesium levels have a stimulatory effect on this tumor type, in contrast to other types of cancer cells where elevated sodium and chlorine and lowered potassium levels have frequently been found.

Adult↗

Disproportional body growth in female estrogen receptor-alpha-inactivated mice.

Estrogens play an important role in the regulation of longitudinal bone growth in man, as demonstrated by recent descriptions of individuals with estrogen insensitivity or aromatase deficiency. Two estrogen receptors, ERalpha and ERbeta, have been cloned. The aim of the present study was to investigate the function of ERalpha in the regulation of body growth and skeletal growth. Adult female mice with inactivated ERalpha (ERalpha-/-) demonstrated an increased body weight compared with wild-type mice (114% of control). However, the length of the appendicular skeleton was decreased in adult ERalpha-/- mice (femur 93% of control). In contrast, the axial skeleton was normal (crown-rump length 98% of control). The decreased growth of the appendicular skeleton was associated with decreased serum levels of IGF-I (77% of control), indicating that the GH/IGF-I axis may be involved in the decreased longitudinal bone growth seen in female ERalpha-/- mice.

Animals↗

[New documentation routines in psychiatry in Västerbotten: unified structure for better quality of care].

During recent decades psychiatric health care has become increasingly complex due to substantial clinical improvements and to the growing need of integrating psychiatric services with other health and welfare services in the community. The traditional psychiatric record format is incompatible both with these requirements and with the practical advantages and difficulties of modern computer technology. In a collaborative effort involving most professional categories at three psychiatric units in the county of Västerbotten in northern Sweden, a new structured format for medical records was developed. The basic feature is a structured summary of background factors, social situation, drug habits, and general health, which is reviewed and updated as necessary. The psychiatric condition is described in some detail, including onset and course, symptomatology, personality factors, diagnosis, treatment results, suicidality, etc. Day to day treatment is outlined in in- and out-patient treatment plans, which are evaluated and revised at regular intervals. The new record format, which is used by all categories of health care professionals, is intended to promote goal-directed treatment and professional collaboration, and is easily adapted to computer technology.

Humans↗

Asthma nurse practice--a resource-effective approach in asthma management.

The objective of this study was to evaluate the efficacy of an Asthma Nurse Practice (ANP) in primary health care. A 12-month (September 1994-August 1995) open, prospective intervention study with pre- and post-test comparisons was performed on patients with asthma treated at a primary care centre in Sweden. Sixty-three patients with mild or moderate asthma participated and medication, structured follow-up and education in self-management at an ANP were assessed over a 12-month period. The main outcome measures assessed were pulmonary function, eosinophil cationic protein (ECP) in serum, respiratory symptoms, patient knowledge of asthma and emergency visits. ANP in primary health care increased patient knowledge of asthma and medication. The number of patients with nocturnal symptoms decreased significantly. Pulmonary function was improved: vital capacity (VC) 98-106, forced expiratory volume in 1 sec (FEV1) 93-100 and peak expiratory flow (PEF) 98-115% of predicted (P < 0.001). Variation in PEF fell from 21 to 12% (P < 0.001). ECP was significantly reduced. Visits to the emergency room were 60% fewer during the year of intervention (P < 0.01). In conclusion, patients attending an Asthma Nurse Practice, comprising a structured programme for asthma management, improve their knowledge and asthma control.

Adult↗

Improvement in skin barrier function in patients with atopic dermatitis after treatment with a moisturizing cream (Canoderm).

Patients with atopic skin show a defective barrier function both in rough and in clinically normal skin, with an increasing risk of developing contact dermatitis. Moisturizing creams are often used in the treatment of dry skin. The purpose of this study was to investigate the influence of treatment with a urea-containing moisturizer on the barrier properties of atopic skin. Fifteen patients with atopic dermatitis treated one of their forearms twice daily for 20 days with a moisturizing cream. Skin capacitance and transepidermal water loss (TEWL) were measured at the start of the study and after 10 and 20 days. On day 21 the skin was exposed to sodium lauryl sulphate (SLS) and on day 22 the irritant reaction was measured non-invasively. Skin capacitance was significantly increased by the treatment, indicating increased skin hydration. The water barrier function, as reflected by TEWL values, tended to improve (P = 0.07), and the skin susceptibility to SLS was significantly reduced, as measured by TEWL and superficial skin blood flow (P < 0.05). Thus, it seems that certain moisturizers could improve skin barrier function in atopics and reduce skin susceptibility to irritants. The mechanism and the clinical relevance need further investigation.

Adult↗

Quality of life, health-state utilities and willingness to pay in patients with psoriasis and atopic eczema.

Skin diseases have been shown to have a significant adverse impact on the health-related quality of life of patients that may be underestimated by objective assessments of clinical severity. The main aim of this study was to measure the health-state utilities on a scale between 0 (dead) and 1 (full health) of patients with psoriasis and atopic eczema, and to measure the willingness to pay for a cure for psoriasis and atopic eczema. A second aim was to analyse how these measures are related to different dimensions of health-related quality of life, as measured by general and disease-specific quality of life instruments and a subjective measure of disability activity. This study was based on data from a questionnaire administered to, and interviews conducted with, 366 patients with psoriasis and atopic eczema aged 17-73 years, attending the dermatology outpatient clinic in Uppsala, Sweden from November 1996 to December 1997. The survey included: a rating scale question, a time trade-off question, a standard gamble question, a dichotomous choice willingness to pay question, a bidding-game willingness to pay question, a generic quality of life instrument (SF-36), a disease-specific quality of life instrument (the Dermatology Life Quality Index) and a subjective measure of disease activity (on a visual analogue scale). The mean health-state utility was 0.69 (rating scale), 0.88 (time trade-off) and 0.97 (standard gamble) for patients with psoriasis. The corresponding health-state utilities for patients with atopic eczema were 0.73, 0.93 and 0.98. On average, patients were willing to pay between 1253 and 1956 Swedish crowns (SEK) per month for a psoriasis cure and between SEK 960 and 1083 per month for an atopic eczema cure ($1 = SEK 8.25 and pound1 = SEK 13.23). The health-state utilities were related to SF-36, the Dermatology Life Quality Index and disease activity in the expected direction and the correlations were strongest for rating scale and weakest for standard gamble. The willingness to pay was correlated with the Dermatology Life Quality Index and disease activity, but not with SF-36. The study indicates that it is feasible to measure health-state utilities and willingness to pay in this patient population, and the sizeable willingness to pay suggests that skin diseases are associated with substantial reductions in quality of life.

Adolescent↗

Elemental analysis mirrors epidermal differentiation.

Using a scanning nuclear microprobe, the distribution of elements and trace elements of skin cross sections of normal skin, non-lesional psoriatic skin and in dry atopic skin have been mapped. In non-lesional psoriatic skin and in dry atopic skin the epidermal Ca-gradient is higher than that of normal skin. In addition, abnormally high Fe and Zn levels were recorded in the stratum granulosum and corneum regions in the pathological skin. It is suggested that these findings correlate to an increased cell turnover in the basal cell layer of the psoriatic and atopic skins. The ratio of Ca/Zn in stratum corneum of paralesional psoriatic skin is approximately 8:1 compared to 12: 1 in normal skin and 15: 1 in atopic skin. This suggests that the differentiation process in paralesional psoriatic skin may actually be an example of disturbed programmed cell death.

Adult↗

IgE myeloma: a case presentation and a review of the literature.

In the literature, fewer than 40 cases of IgE myeloma have been described. We report the first Norwegian case, an 80-year-old man presenting with progressive weakness, dyspnea and dizziness. With the exception of hypersedimentation, routine chemistry values were within reference limits. Plasma cells were not observed in the peripheral blood. Serum protein electrophoresis showed a monoclonal protein in the gammaglobulin fraction. Immunofixation confirmed the presence of an IgE kappa monoclonal protein. A bone marrow biopsy revealed an interstitial and nodular infiltration of abnormal plasma cells comprising 40% of nucleated cells present. Skeletal roentgenograms of this patient showed osteolytic lesions in the skull and in the left pubic arc. The findings for this patient were compared with the previous reports of IgE myeloma.

Aged↗

Biophysical characterization of skin damage and recovery after exposure to different surfactants.

The majority of adverse skin reactions to personal-care products are presumed to be caused by irritant substances, like surfactants. In this study, different aspects of the irritant reaction after a single exposure to 8 surfactants were characterized during 2 weeks. Solutions of 2% sodium lauryl sulfate, 5% sodium C12-15 pareth sulfate, 5% sodium cocoyl isethionate, 10% disodium laureth sulfosuccinate, 10% sodium cocoamphoacetate, 10% cocamide DEA, 10% cocamidopropyl betaine and 10% lauryl glucoside, respectively, were applied to the forearm of 12 volunteers. Clinical assessment, an evaporimeter, a laser Doppler flowmeter and a corneometer were used for evaluation. The surfactants induced different degrees of irritation. Erythema, transepidermal water loss and skin blood flow exhibited a similar time course, which seemed to be inversely related to the delayed scaling and reduced skin capacitance. The mechanism of the damaging effect of the surfactants seems to be similar, although some minor differences were noted.

Adult↗

[Alendronate].

Explore the source record for details and available documents.

Aged↗

Identification of the binding site for a low-molecular-weight inhibitor of plasminogen activator inhibitor type 1 by site-directed mutagenesis.

A novel low-molecular-weight inhibitor, AR-H029953XX, was developed from a known fibrinolytic compound, flufenamic acid, which prevented complex formation of human plasminogen activator inhibitor type 1 (PAI-1) with tissue plasminogen activator (tPA) by inhibition of PAI-1. To explore the binding site for AR-H029953XX, mutants of human PAI-1 were constructed by site-directed mutagenesis and were then expressed in CHO cells, purified, activated, and characterized. (1) PAI-1 with mutations in the reactive center loop: L1-PAI-1 (P10, Ser337Glu) had stability and activity similar to those of wild-type PAI-1 (wt-PAI-1), and L2-PAI-1 (P12, Ala335Glu) was highly stable but was a substrate for tPA. (2) PAI-1 with mutations near the binding epitope for the strongly inhibiting monoclonal antibody CLB-2C8: C1-PAI-1 (Phe114Glu), C2-PAI-1 (Val121Phe), C3-PAI-1 (Arg76Glu/Arg115Glu/Arg118Glu), and C4-PAI-1 (Arg115Glu) were all comparable in activity and stability to wt-PAI-1. AR-H029953XX (Ki = 25 microM) prevented complex formation between tPA and active wt-PAI-1 as well as that with mutants L1-, L2-, C1-, C2-, and C4-PAI-1. AR-H029953XX also inhibited binding of these PAI-1 variants to the antibody CLB-2C8, as measured by surface plasmon resonance. In contrast, AR-H029953XX had almost no inhibitory effect on the complex formation of tPA with C3-PAI-1. Moreover, AR-H029953XX had no effect on the binding rate of CLB-2C8 to C3-PAI-1, or on the binding to latent PAI-1 or to cleaved L2-PAI-1. The binding site of AR-H029953XX thus appears to be located in the neighborhood of the postulated epitope for CLB-2C8, near residues Arg76 and/or Arg118. This specific domain of the PAI-1 molecule might thus also be important for the mechanism of inhibitory activity toward tPA. Moreover, the structure of this region in active PAI-1 has to be different from the corresponding regions in latent and cleaved PAI-1.

Animals↗

Assessment of ability/disability in patients treated with chronic thalamic stimulation for tremor.

Chronic thalamic stimulation (CTS) has a documented good effect on tremor in patients with Parkinson's disease (PD) and essential tremor (ET). This study evaluates whether the alleviation of impairment, i.e., tremor, translates into improvement of the patient's ability in performing instrumental activities of daily living (IADL). Thirteen patients were assessed with an occupational therapy tool called Assessment of Motor and Process Skills (AMPS). This observation-based scale rates the patient's motor and process skills needed to perform a given task. The evaluations were done at a mean of 13 months after surgery in the patient's home, and included assessments of IADL with the CTS activated and switched off, respectively. The results showed that most patients improved to variable degrees in their IADL ability when the thalamic stimulation was on. The improvement was more marked in patients operated on for tremor of their dominant hand. The improvement concerned mainly the skill items related to the patients' abilities of coordination, calibration, endurance, and accommodation during IADL task performance. The authors concluded that for some patients with tremor, CTS can improve independence in domestic activities of daily living.

Activities of Daily Living↗

Effects of the carbonic anhydrase inhibitor acetazolamide on splanchnic blood flow in anaesthetized rats.

The aim of the present study was to evaluate whether inhibition of the enzyme carbonic anhydrase with acetazolamide interfered with pancreatic islet and whole splanchnic blood perfusion in rats. Carbonic anhydrase is present both in the endocrine cells and, in particular, the endothelium of the pancreatic islet. Thiobutabarbital-anaesthetized, male Sprague-Dawley rats were used in all experiments, and acetazolamide (50 mg/kg body weight) was given to untreated control rats or rats pretreated with glucose, i.e. to normoglycaemic and hyperglycaemic animals. No acetazolamide-induced effects on blood glucose or serum insulin concentrations, mean arterial blood pressure, whole pancreatic or islet blood flow were seen in any of the animals. There were no effects on duodenal or colonic blood flow recorded in the control rats, whereas an increase in duodenal blood flow (P<0.02) was observed in the hyperglycaemic animals. A tendency to an increase was seen in colonic blood flow in hyperglycaemic animals, although this was not statistically significant (P = 0.069). Inhibition of carbonic anhydrase seems to induce only minor effects on pancreatic blood flow, while duodenal blood flow is slightly enhanced in hyperglycaemic animals.

Acetazolamide↗

Multiple basal cell carcinoma. A clinical evaluation of risk factors.

Basal cell carcinoma (BCC) is the most common malignant skin tumour. There is evidence that the number of patients who develop more than one basal cell carcinoma (mBCC) is increasing. The aim of this study was to elucidate possible risk factors for developing mBCC. Among twelve risk factors considered, skin tumour among relatives was the strongest, with an odds ratio of 10.9 (p < 0.001). The second strongest risk factor was sunburn after the age of 60, odds ratio 4.4 (p < 0.001). The results suggest that the presence of skin tumour in the family and sunburn after age 60 are independent factors associated with mBCC. To our knowledge this has not previously been reported.

Aged↗

Differential epidermal expression of the invariant chain in allergic and irritant contact dermatitis.

Allergic contact dermatitis and irritant contact dermatitis have different pathogenic mechanisms. It is therefore plausible that the epidermal expression of HLA-DR and the invariant chain associated with antigen processing and presentation might differ between allergic contact dermatitis and irritant contact dermatitis. We have quantified the volume of epidermal HLA-DR and invariant chain reactivity and the total epidermal volume in allergic contact dermatitis and irritant contact dermatitis using confocal laser scanning microscopy and indirect immunofluorescence on acetone-fixed 25 microns thick vertical skin sections. Eight nickel allergic patients were patch-tested with 5% nickel sulfate and 8 healthy volunteers were patch-tested with 4% sodium lauryl sulfate. Skin biopsy specimens were taken at 0, 6, 24, and 72 h after application of the patch tests. Sodium lauryl sulfate induced a statistically significant increased epidermal volume at 24 h and 72 h compared to 0 h and 6 h (p < 0.003 and p < 0.001, respectively), whereas an increase in epidermal volume in the allergic contact dermatitis group was not noted until 72 h after patch testing with nickel sulfate compared to 0, 6 h (p < 0.001) and 24 h (p < 0.004). No significant changes in the epidermal volume of HLA-DR reactivity were found at any time point within or between the two groups, nor was there any significant change in the epidermal volume of invariant chain reactivity in the allergic contact dermatitis group. In the irritant contact dermatitis group, however, the epidermal volume of invariant chain reactivity was significantly reduced from 17 +/- 8 x 10(3) microns 3 at 24 h to 9 +/- 3 x 10(3) microns 3 at 72 h (p < 0.04), which was also significantly lower than the 14 +/- 4 x 10(3) microns 3 observed in allergic contact dermatitis at 72 h (p < 0.01). Furthermore, the invariant chain expression was significantly lower than the HLA-DR reactivity in the irritant contact dermatitis group at 72 h (p < 0.001). The decrease of invariant chain reactivity at 72 h in irritant contact dermatitis might reflect an epitope-induced alteration by sodium lauryl sulfate or a down-regulated biosynthesis of the invariant chain due to variance in local cytokine production between allergic contact dermatitis and irritant contact dermatitis.

Adult↗