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Biomedical subjects

P Sundström

Publications and source records attributed to P Sundström.

At least 19 recordsLinked to original sources
PubMed2004

Neurofilament and glial fibrillary acidic protein in multiple sclerosis.

OBJECTIVE: To evaluate levels of neurofilament light (NFL) and glial fibrillary acidic protein (GFAP) in CSF from patients with multiple sclerosis (MS) in relation to clinical progress of the disease. METHODS: CSF levels of NFL and GFAP were determined by sensitive ELISAs in 99 patients with different subtypes of MS, classified in terms of "ongoing relapse" or "clinically stable disease," and 25 control subjects. Levels were compared with paraclinical data such as immunoglobulin G index and inflammatory cell count in the CSF, and the levels were related to Expanded Disability Status Scale score and progression index at clinical follow-up evaluations later in the disease course. RESULTS: NFL and GFAP levels were elevated in MS patients as compared with control subjects (p < 0.001). The NFL levels were higher at relapses, whereas GFAP levels were unaffected. High NFL levels correlated with progression in patients with an active relapse (r = 0.49; p < 0.01) and in clinically stable patients (r = 0.29; p < 0.05). GFAP correlated to progression in the total patient cohort (r = 0.24; p < 0.05). Moreover, a strong correlation between NFL levels and inflammatory cell counts was evident in the group of patients with an ongoing relapse (r = 0.52; p = 0.001). CONCLUSIONS: CSF levels of neurofilament light and glial fibrillary acidic protein may have prognostic value in multiple sclerosis.

Adult↗
PubMed2004

An altered immune response to Epstein-Barr virus in multiple sclerosis: a prospective study.

OBJECTIVE: To investigate the association between human herpesviruses and multiple sclerosis (MS), as well as between measles virus and MS. METHODS: The authors identified prospectively collected serum samples from 73 MS cases and retrospective sera from 161 MS cases in two population-based serum bank registers. Analyses of IgG antibody responses in cases and matched referents were performed for Epstein-Barr virus (EBV [EBNA-1 and VCA]), human herpesvirus 6 (HHV-6), herpes simplex virus (HSV), varicella zoster virus (VZV), and measles. RESULTS: All cases showed signs of past EBV infection. High activity to EBNA-1 and HHV-6 significantly (borderline significance for HHV-6) increased the risk for MS in prospective sera. A discrepancy between activities to EBNA-1 and VCA was striking in MS samples collected less than 5 years before relapsing-remitting MS onset, where high activity to EBNA-1 significantly increased, and high VCA activity significantly decreased the risk for MS. There was no support for major causal roles for HSV, VZV, or measles. CONCLUSION: Individuals who will develop MS exhibit an altered immune response against the EBV virus characterized by a high IgG activity to EBNA-1 in the absence of high activity to VCA, this being most pronounced in the 5-year period preceding MS onset.

Adolescent↗
PubMed2004

Clinical characteristics of multiple sclerosis in Västerbotten County in northern Sweden.

BACKGROUND: Most clinical data for multiple sclerosis are hospital based-that is, derived from patients referred to clinics specialising in the disease. OBJECTIVES: To present data derived from two population based multiple sclerosis populations, an incidence cohort and a prevalence population, from Västerbotten County, northern Sweden. METHODS: The two populations were identified from multiple sources, and case ascertainment was assured through a personal clinical review, including interviews and examination of the patients. RESULTS: Characteristics at onset for the different clinical subtypes of multiple sclerosis are presented, including the clinical spectrum of the first attack, the anatomical correlation between the first and second attacks, sex distribution, and disability distribution. CONCLUSIONS: Based on the comparison of present and earlier natural history data, multiple sclerosis appears to be a slightly more benign disease than previously recognised.

Adult↗
PubMed2003

Native and transformed alpha2-macroglobulin in plasma from patients with multiple sclerosis.

Multiple sclerosis (MS) is an inflammatory demyelinating disease with unknown etiology. Various proteinases have been observed in increased levels in the central nervous system of patients with MS, which may contribute to the release of immunogenic myelin components. alpha2-Macroglobulin (alpha2M) inhibits a broad spectrum of proteinases sterically, undergoing major conformational changes induced by the proteinases themselves. Moreover, alpha2M acts as a carrier of several cytokines in the systemic circulation. By use of radial immunodiffusion, we determined the total alpha2M levels in plasma from 28 MS patients and 15 control subjects [14 patients with other neurologic diseases (OND) and one healthy individual]. No significant differences in total alpha2M concentration were observed between the MS patients and the control subjects. A comparison of the degree of alpha2M transformation in MS patients with different disease courses and controls was performed, using monoclonal antibodies (mAbs) specific for binding to native and transformed alpha2M, respectively. The fractions of transformed alpha2M were significantly increased in patients with secondary or primary progressive disease course compared with the controls. No significant differences were obtained using a native-specific mAb. At least a major proportion of alpha2M from the MS patients was able to change conformation from its native to its transformed state, as demonstrated by a shift in mAb reactivity, following methylamine treatment of the plasma samples. In conclusion, the results indicate that plasma alpha2M may be inactivated at a higher degree in patients with chronic progressive MS compared with patients with OND. This may influence the levels of proteinases and cytokines in the systemic circulation and may furthermore have diagnostic implications.

Adult↗
PubMed2003

Incidence (1988-97) and prevalence (1997) of multiple sclerosis in Västerbotten County in northern Sweden.

OBJECTIVE: To investigate the incidence and prevalence of multiple sclerosis in Västerbotten County in northern Sweden. METHODS: Multiple sources were used in the case identification process. Follow up interviews with clinical examinations were undertaken and, when indicated, additional paraclinical investigations were done. In this way case ascertainment was assured and supplemental clinical data were collected. The incidence rate was based on symptom onset. Onset adjusted prevalence was applied. RESULTS: The crude incidence rate of multiple sclerosis in 1988-97 in Västerbotten County was 5.2/10(5) (95% confidence interval, 4.4 to 6.2): 6.7/10(5) (6.0 to 8.3) in women and 3.7/10(5) (2.7 to 4.9) in men. The onset adjusted prevalence for 31 December 1997 was 154/10(5) (139 to 170): 202/10(5) (179 to 228) in women and 105/10(5) (89 to 125) in men. When compared with a previous estimate of prevalence, a yearly 2.6% increase in prevalence between 1990 and 1997 was found, mainly attributable to a higher incidence than mortality. CONCLUSIONS: The present incidence rate and prevalence confirms earlier findings that Västerbotten is a high risk area for multiple sclerosis. The adjusted incidence was twice as high as the incidence from 1974-88 in the only previous Swedish population based study from Göteborg, but comparable with other recent Fennoscandian multiple sclerosis incidence rates.

Adolescent↗
PubMed2003

Sick leave and professional assistance for multiple sclerosis individuals in Västerbotten County, northern Sweden.

The aims of this study of a cross-sectional multiple sclerosis (MS) population in Västerbotten County, northern Sweden, were to estimate the prevalence of sick leave, professional assistance and housing; to study risk factors for sick leave; and to estimate the odds for sick leave in comparison with the general population of the county. The consequences of MS-related incapacity on the socioeconomic factors studied were considerable. Almost half (45%) of prevalent MS cases aged 18-64 years were fully sick listed and only one-third (35%) were not sick listed at all. Every fourth individual in the prevalence population received professional assistance, and 9% were living in care homes or special apartments for the disabled. Multiple logistic regression analysis identified the Expanded Disability Status Scale (EDSS) as the strongest predictor of sick leave. The time from symptom onset to full sick leave leading to temporary or permanent disability pension was significantly shorter for cases with progressive onset, higher age at onset and in males. The risk of full sick leave due to MS was six times higher than in the general population.

Adolescent↗
PubMed2001

Prevalence of multiple sclerosis in Västerbotten County in northern Sweden.

OBJECTIVE: To estimate the prevalence and clinical characteristics of multiple sclerosis (MS) in Västerbotten County in northern Sweden. METHODS: Individuals with MS were identified from several sources. A follow-up interview and/or examination was performed in 94% of cases still living in the area during 1997-99. Onset adjusted prevalence and a definition of onset symptoms were applied. RESULTS: A total of 313 cases were identified, resulting in an onset adjusted crude prevalence of MS for January 1990 of 125/105 (95% confidence interval (CI): 112-140). Female predominance was evident (163/105 (95% CI: 142-187) vs 86/105 (95% CI: 71-104)). Diagnostic coding registers were the most important source for identification of cases. CONCLUSIONS: The crude prevalence of MS in Västerbotten was higher than previous reports from other major areas in Scandinavia. The adjusted prevalence was significantly higher when compared with a previous study from Göteborg, south-western Sweden. The methodology used in this study gives a high degree of case ascertainment and increases the comparability of multiple sclerosis epidemiological studies.

Adolescent↗
PubMed1999

Expression of envelope proteins of endogeneous C-type retrovirus on the surface of mouse and human oocytes at fertilization.

Retrovirus genomes express, among other products, the envelop (env) proteins SU (gp70) and TM (p15E). They coexist at the viral surface membrane and are able to promote immunosuppression and membrane fusion. In mouse oocytes, endogeneous retroviruses (ERV) genomes are expressed at fertilization, and antigen epitopes of the Moloney murine leukemia virus (MuLV) env protein gp70 are recognized in the cytoplasm of the oocytes before but not after fertilization. By using a panel of monoclonal antibodies (mAbs) raised against env components, we checked with laser scanning confocal microscopy (LSCM) whether gp70 and p15E were expressed also on the oocyte surface membrane (oolemma). Since we found that both mouse and human unfertilized oocytes expressed these ERV proteins on the oolemma and that the expression enfeebled significantly after fertilization, we assume that ERV genomes could play a role at the sperm-egg binding and fusion.

Animals↗
PubMed1998

Interpreting the notion that technology is value-neutral.

Value-freedom or value-neutrality is a well-known topic in the philosophy of science. But what about the value-neutrality of technology, medical or other? Is it too far-fetched to imagine technology as in some sense value-neutral--in view of its intimate connection with purposeful human action? No; unexpected perhaps, but less far-fetched than expected. If we try to conceive of technology as a cognitive possibility abstracted from each and every specific social context, we shall find (at least) three senses in which it may be regarded as value-neutral: (1) neutral vis-à-vis different possible uses and ends; (2) neutral before action; (3) neutral qua cognitive object, analogous to the cognitive core of science. The further meanings and implications of these three senses of value-neutrality are discussed. What is this exercise good for? The nature of technology is indeed worth pondering in its own right, not least from this rather unusual angle. But beyond that: as the possible meanings of value-neutrality are tried out, the radical nature of human responsibility for the social implementation of technology will be highlighted.

Diffusion of Innovation↗
PubMed1998

Establishment of a successful pregnancy following in-vitro fertilization with an endometrial thickness of no more than 4 mm.

Intrauterine pregnancy after superovulation with gonadotrophins and after in-vitro fertilization (IVF) and embryo replacement has not been reported to occur in cases where the thickness of the pre-ovulatory endometrium was <6 mm. We report a case where an intrauterine pregnancy was established where the endometrium was no more than 4 mm in thickness at the time of follicular aspiration. It is suggested that an IVF cycle should not necessarily be abandoned merely because the pre-ovulatory endometrium is thin, and especially if other parameters, including follicular development and serum oestradiol concentrations, are appropriate.

Adult↗
PubMed1998

Confocal laser fluorescence scanning microscopy of the oolemma distribution of monoclonal antibodies against mouse and human egg surface membrane.

Monoclonal antibodies were raised against zona-free mouse oocytes by intrasplenic immunizations. Antibodies, which detected antigen epitopes in unfertilized but not in fertilized mouse eggs (fertilization-specific antibodies) and which in addition recognized epitopes in unfertilized human oocytes (mouse-human cross-reacting antibodies) were used to visualize the distribution of their corresponding antigens by confocal laser fluoresence scanning microscopy (CLFSM). We found that among 26 antibodies tested, two ones showed a patch pattern. Since a patchy distribution of cell membrane molecules indicates the presence of integral proteins with ability to transduce signals to the cytoplasm, we suggest that the method here applied will select for those oolemma molecules that could be involved in the fusion of sperm cells.

Animals↗
PubMed1996

Human autoantibodies recognizing human and mouse preimplantation stages.

PROBLEM: To find out whether autoantibodies against human preimplantation stages are present in some human sera and, if so, whether the antibodies could be capable to affect the egg development and/or to trigger an activation of the complement system at the procedures of assisted conception. METHODS: 1. Immunohistochemistry on blots of human preimplantation stages. 2. Immunohistochemistry on paraffin sections of human and mouse preimplantation stages. 3. Culture of mouse morulae to analyze complement activation. RESULTS: 1. Some human sera contained autoantibodies against human preimplantation stages. 2. Human-mouse cross-reacting antibodies against preimplantation stages occurred. 3. Immune complexes, formed on mouse preimplantation stages, activated the complement systems in egg cultures, resulting in a damaging of the eggs. CONCLUSION: The presence of natural autoantibodies to preimplantation stages may be associated with reproduction failure, caused by a direct effect by the autoantibodies and/or an activation of the uterine complement system by the immune complexes formed.

Animals↗
PubMed1995

Peter Singer and 'lives not worth living'--comments on a flawed argument from analogy.

The Australian bioethicist Peter Singer has presented an intriguing argument for the opinion that it is quite proper (morally) to deem the lives of certain individuals not worth living and so to kill them. The argument is based on the alleged analogy between the ordinary clinical judgement that a life with a broken leg is worse than a life with an intact leg (other things being equal), and that the broken leg therefore ought to be mended, on the one hand, and the judgement that the lives of some individuals, for example, severely disabled infants, are not worth living and therefore ought to be terminated, on the other. In the present article it is argued that Singer's argument is flawed, intellectually and/or ethically.

Bioethics↗