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Biomedical subjects

S Larsson

Publications and source records attributed to S Larsson.

At least 199 records · Page 11Linked to original sources
PubMed1992

Long-term follow-up of patients with untreated scoliosis. A study of mortality, causes of death, and symptoms.

The mortality and causes of death in 115 patients (80 women), born 1902-1937, with untreated scoliosis were compared to the expected according to official Swedish statistics. Subgrouping for cause and onset of scoliosis was done. Fifty-five patients had died; 21 of respiratory failure and 17 of cardiovascular diseases. The mortality was significantly (P less than 0.001) increased. The increased risk was apparent at 40-50 years of age. The mortality was significantly increased in infantile (P less than 0.001) and juvenile (P less than 0.01) scoliosis but not in adolescent scoliosis. The mortality was also increased in post-polio scoliosis, scoliosis combined with rickets and scoliosis of unknown etiology indicating an increased mortality in idiopathic scoliosis. Among the surviving patients anti-hypertensive treatment was frequent (23 of 50).

Adolescent↗
PubMed1992

Propofol-fentanyl anesthesia compared to thiopental-halothane with special reference to recovery and vomiting after pediatric strabismus surgery.

Forty-four children, ASA physical status I or II, aged 1.5-14 years and admitted for strabismus surgery, were studied. The study compared the postoperative condition after two different anesthesia methods. All children were premedicated with midazolam rectally, received glycopyrrolate i.v. and were then randomised to one of two anesthetic methods: 1) induction with thiopental, maintenance with halothane or 2) induction with propofol supplemented with fentanyl, maintenance with propofol infusion. In both groups, tracheal intubation was performed after vecuronium i.v. and the children were ventilated manually. Peroperatively, patients receiving propofol/fentanyl had more episodes of bradycardia (P less than 0.001). Times to spontaneous breathing and extubation were shorter in the propofol/fentanyl group (P less than 0.05) and there was also a lesser degree of sedation during the first 2 h postoperatively (P less than 0.01). Fewer children in the propofol/fentanyl group vomited postoperatively (P less than 0.05). The apprehension score was higher in the propofol/fentanyl group compared to the thiopental/halothane group (P less than 0.05). We conclude that children undergoing strabismus surgery anesthetized with propofol/fentanyl had more episodes of peroperative bradycardia, a lower incidence of postoperative vomiting and a shorter recovery time, and were more apprehensive during the initial postoperative period than children anesthetized with thiopental/halothane.

Adolescent↗
PubMed1992

Remission rate after thymectomy in myasthenia gravis when the bias of immunosuppressive therapy is eliminated.

The clinical course of all 86 myasthenia gravis (MG) patients who were thymectomized at Sahlgrenska Hospital between 1955 and 1980 was evaluated in order to estimate what the rate of complete clinical remission (with or without anticholinesterase medication) would be without immunosuppressive (IS) therapy; 19 of 73 patients without thymoma received IS therapy. A suitable way of dissociating the course after thymectomy from the influence of IS therapy is the Markov method. The calculated probability of remission was 0.18, 0.35, 0.43, 0.53 and 0.56 in the 0-1, 2-3, 4-5, 5-10 and more than 10-year periods after thymectomy. A similar result (53 +/- 7%) was obtained by a life-table method with censoring of IS-treated patients when they received such therapy. Time to remission was significantly shorter for patients with age of MG onset before 35 years. Timing of IS therapy after thymectomy is discussed, considering the post-thymectomy remission rate.

Adult↗
PubMed1992

A randomized trial comparing the use of fresh and stored platelets in the treatment of bone marrow transplant recipients.

Patients undergoing allogeneic bone marrow transplantation (BMT) were randomized into two groups. One group (n = 21) received single donor platelet concentrates (PC) that were as fresh as possible, the other group (n = 18) received single donor PC stored for 2 to 5 days. Actual mean storage times for PC were 1.12 +/- 1.25 (mean +/- SD) and 2.67 +/- 1.30 d, respectively (p < 0.001). The total need for platelets during 60 d after BMT in patients receiving fresh PC was 22.1 +/- 17.8 x 10(9) platelet/liter blood volume/d, and for stored PC 29.2 +/- 19.2 x 10(9) platelets/liter blood volume/d (n.s.). A multiple regression analysis of the data showed no correlation between PC storage time and the PC requirement (p = 0.85). Posttransfusion corrected count increment (CCI) at 1 hour was 10.4 +/- 5.1 for PC stored 0-1 d, 10.3 +/- 7.0 for PC stored 2-3 d, and 11.4 +/- 9.2 for PC stored 4-5 d. The corresponding CCI, at 18 h were 6.5 +/- 4.4, 5.4 +/- 3.3 and 6.8 +/- 4.6. We conclude that there is no major difference between fresh and stored single donor PC.

Adolescent↗
PubMed1992

Chest x ray films from construction workers: International Labour Office (ILO 1980) classification compared with routine readings.

The extent of agreement between International Labour Office (ILO) and clinical readings of chest x ray films from construction workers was studied. From a survey of 5898 workers 258 subjects with a profusion of small opacities of > or = 1/1 and a stratified sample of subjects with profusion < 1/1 were selected. Only 41% of the films classified as ILO profusion category > or = 1/1 were clinically recorded as non-normal for the parenchyma. The proportion of films recorded as pneumoconiotic (or possibly so) was especially low for irregular opacities (22%), but increased with the profusion category (both rounded and irregular) as well as with the size of rounded opacities (p 3/11, q 12/25, r 3/4). Only with the profusion category > or = 2/1 were most of the films recorded as pneumoconiotic. The specificity and sensitivity were highest in the geographical areas where a few clinical readers had assessed many films each. The proportion of false negative clinical reports was low for circumscribed pleural thickening of the chest wall (9%) and diaphragmatic pleural thickening (6%). For calcified pleural changes and for the combination of diffuse pleural thickening and obliteration of the costophrenic angle, false negative reports were absent. The present study shows an unsatisfactory sensitivity for clinical compared with ILO readings as a means for screening the parenchyma of workers with a risk of pneumoconiosis.

Humans↗
PubMed1992

Coexpression of ganglioside antigen Fuc-GM1, neural-cell adhesion molecule, carcinoembryonic antigen, and carbohydrate tumor-associated antigen CA 50 in lung cancer.

With the aid of specific monoclonal antibodies, tumor tissues from 68 patients with lung cancer were examined for their expression of two small cell lung carcinoma (SCLC) antigens, Fuc-GM1 (fucosyl GM1; IV2FucII3NeuAc GgOse4) and neural-cell adhesion molecule (NCAM), and two broader tumor antigens, carcinoembryonic antigen (CEA) and carbohydrate cancer-associated antigen CA 50. Expression of Fuc-GM1 was seen in 75% and NCAM in 78% of the SCLC specimens, but also in 12 and 20% of non-SCLC. Either or both of these antigens were expressed in more than 90% of SCLC and in 25% of non-SCLC. CEA was found in more than 80% of SCLC and non-SCLC. Expression of CA 50 was seen in 65-68% of non-SCLC and SCLC, showing preference for SCLC and lung adenocarcinoma. In SCLC, cellular expression of Fuc-GM1 was generally seen together with NCAM and CA 50, but rarely with CEA. There was considerable inter- and intratumor heterogeneity in the expression of all four antigens. The results suggest that CEA is the antigen of choice for the detection of lung cancer regardless of histotype. In combined analysis of CEA, CA 50, Fuc-GM1 and NCAM, two patterns of antigen expression were recognized that appear to discriminate between SCLC and non-SCLC tumors, respectively. A considerable fraction of SCLC and non-SCLC tumors, however, exhibited similar patterns of antigen expression. The biological and clinical significance of these observations remains to be investigated.

Antibodies, Monoclonal↗
PubMed1992

Nasopharyngeal bacterial flora in otitis prone children treated with immunoglobulin.

The present study was undertaken to evaluate possible beneficial effects of regularly given, long term immunoglobulin prophylaxis of children below 2 years of age with recurrent acute otitis media (RAOM). The nasopharyngeal bacterial flora and the frequency of acute otitis media (AOM) and secretory otitis media SOM were studied. Every second of 44 children with 3 or more periods of AOM during the last year received immunoglobulin intramuscularly (Gammaglobulin Kabi 165 mg/l, 0.45 ml/kg b.w.) every third week for 6 months, while the other 22 children served as controls. All children were followed for 12 months. Immunoglobulin prophylaxis neither influenced the nasopharyngeal flora, nor the frequency of AOM or SOM periods. Children with AOM or SOM more often harbored bacterial pathogens in their nasopharynx than children with normal middle ear status. Also, the immunoglobulin prophylaxis did not influence the increased frequency of bacterial pathogens in the nasopharynx of children attending public day care or family day care as compared to those taken care of at home.

Acute Disease↗
PubMed1992

Oral cefadroxil prophylaxis in hip fracture surgery. Serum concentrations studied in 17 patients.

Serum concentration-time curves were determined in seventeen 82 (60-90) year-old patients undergoing trochanteric hip fracture surgery after receiving 1 g of cefadroxil per os. All the patients attained a serum level of antibiotic high enough to inhibit the growth of Staphylococcus aureus and S. epidermidis. When orally administered, cefadroxil should be given within 2 hours before surgery.

Aged↗
PubMed1992

Determination of functional kidney volume by single-photon emission computed tomography in patients with insulin-dependent diabetes mellitus.

Functional parenchymal kidney volume was determined by single-photon emission computed tomography (SPECT) for 99mTc-dimercaptosuccinic acid (DMSA) using a rotating gamma camera in phantom experiments and in patients with insulin-dependent diabetes mellitus (IDDM). The results from the patient examinations were corrected according to the phantom studies and were thereafter set in relation to renal haemodynamics, blood pressure, and urinary albumin excretion. Functional parenchymal kidney volume was significantly greater in diabetic patients compared to that of 11 healthy controls (P < 0.003). Urinary albumin excretion was increased and glomerular filtration rate (GFR) per renal parenchymal volume significantly less in patients with a duration of diabetic disease of more than 15 years compared to patients with shorter duration of disease (P < 0.03 and P < 0.05 respectively). Diabetic patients with a GFR of more than 120 ml/min had greater renal parenchymal volume than patients with lower GFR (P < 0.02). Patients with increased GFR, renal plasma flow (RPF), renal blood flow, or filtration fraction had significantly greater functional parenchymal volume than the healthy subjects (P < 0.01 for all comparisons). We conclude that by application of SPECT for DMSA we were able to show that IDDM patients have greater renal parenchymal volumes than healthy subjects. GFR/kidney volume was increased in IDDM patients with a duration of disease of < 15 years compared to patients with long-standing diabetes. The SPECT technique seems suitable for prospective long-term follow-up studies of functional kidney volume in IDDM patients.

Adult↗
PubMed1992

Technical options in reconstruction of large mediastinal veins.

Twelve patients who underwent graft replacement of the large mediastinal veins were reviewed. A preoperative superior vena caval (SVC) syndrome was present in seven patients. The most frequent diagnosis was a primary thoracic malignant neoplasm (10 patients). Reconstruction was performed with a pericardial tube in four patients, venae saphena magna in three patients, umbilical vein in three patients, and Dacron grafts in two patients. A temporary bypass was used in three patients. All the patients survived the operation. Eight patients died within 15 months of the surgery. Four patients are long-term survivors without signs of an SVC syndrome. Based on our experience and a review of the literature, we recommend the use of two autogenous vein grafts or a ringed polytetrafluoroethylene graft with a diameter of about one half that of the normal SVC to replace the large mediastinal veins.

Adult↗
PubMed1992

A bronchoscopic brush biopsy study of large airway mucosal pathology in smokers with chronic bronchitis and in healthy nonsmokers.

We investigated the use of bronchial brush biopsies of the bronchial epithelium as a diagnostic tool in common airway diseases. Flexible fibreoptic bronchoscopy was performed on 22 smokers with nonobstructive chronic bronchitis and on 14 healthy nonsmoking individuals. Ten of the smokers had recurrent infectious exacerbations. Cell samples were taken from carinal and subsegmental levels of the bronchial tree with a standard cytological brush, and a differential count was made of the different cell types. Smokers with chronic bronchitis had significantly more goblet cells (mean 20.0, SD 8.6), and less ciliated epithelial cells (mean 74.1, SD 9.4), than the healthy nonsmokers (mean 9.2, SD 3.9 and mean 84.7, SD 6.6, respectively). No such changes were found between the chronic bronchitis groups with or without infectious exacerbations. Thus, bronchial brush biopsies can be used as a complement to standard bronchial biopsies in the investigation of airway diseases other than pulmonary malignancies.

Biopsy↗
PubMed1992

The risk of lung cancer and mesothelioma after cessation of asbestos exposure: a prospective cohort study of shipyard workers.

A prospective cohort study of 3,893 shipyard workers, mainly exposed to chrysotile, indicated no increased risk of lung cancer 7-15 yrs after exposure to asbestos had ceased. The shipyard workers, however, had an increased risk of pleural mesotheliomas with 11 observed cases versus 1.5 expected. An explanation for these observations may be that asbestos may have different carcinogenic mechanisms in causing lung cancer and mesothelioma. A non-increased risk of lung cancer some years after exposure to asbestos has stopped is in accordance with asbestos acting as a promotor. The high risk of mesothelioma, on the other hand, may indicate that asbestos acts as a complete carcinogen in developing this disease.

Adult↗
PubMed1992

C-reactive protein (CRP) levels after elective orthopedic surgery.

The levels of C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were determined by serial measurements after four types of uncomplicated elective orthopedic surgery. The type of operations chosen for this study were total hip arthroplasty (primary, n = 109; and revisions caused by aseptic loosening, n = 9), unicondylar knee arthroplasty (n = 39), and lumbar microdiskectomy (n = 36). In all patients, CRP levels increased after surgery, reaching peak levels on the third day after hip arthroplasties (primary, 116 +/- 43 mg/l; revisions, 136 +/- 58 mg/l) and on the second day after knee arthroplasties (140 +/- 46 mg/l) and lumbar microdiskectomy (48 +/- 27 mg/l). C-reactive protein levels usually dropped to normal (less than 10 mg/l) within 21 days after surgery. No correlations were found between CRP response and the type of anesthesia, amount of bleeding, transfusion, operation time, administered drugs, age, or gender. Erythrocyte sedimentation rate increased to peak levels about five days after surgery, followed by a slow and irregular decrease. Still, 42 days after uncomplicated operations ESR often remained elevated. In conclusion, the level of CRP must be considered a better diagnostic aid for the early detection of postoperative infections than ESR. It can be assumed that the rapid decline in CRP after uncomplicated orthopedic surgery will be interrupted by a second rise or by a persisting elevated level if infectious complications occur.

Adult↗
PubMed1991

Control of adenovirus alternative RNA splicing: effect of viral DNA replication on RNA splice site choice.

The primary transcripts of most adenovirus transcription units are processed into multiple, alternatively spliced mRNAs. The relative concentrations of such differentially processed mRNAs changes during the infectious cycle. The factors that control this temporal shift in mRNA abundance have not yet been characterized. In the experiments presented here we have examined mRNA synthesis from three viral transcription units: two early regions E1a and E1b, and late region L1. We show that viral DNA replication plays a key role in the control of cytoplasmic mRNA expression from these regions. In the absence of efficient late protein synthesis, viral DNA replication was sufficient to induce a substantial fraction of the E1a, E1b and L1 transcripts to shift from the early to the late pattern of mRNA structure. The shift was not complete under the conditions used, suggesting that viral proteins, although not essential for the process, play an important regulatory role. The requirement for late viral protein synthesis differed between the three transcription units examined. This dependence was most pronounced for correct L1 mRNA production. Viral DNA replication was sufficient to trigger a significant shift in L1 alternative 3' splice site selection. However, in the absence of late translation the L1 pre-mRNA was aberrantly spliced.

Adenovirus Early Proteins↗
PubMed1991

The influence of age on the durability of Carpentier-Edwards biological valves. Thirteen years follow-up.

Two hundred and ninety-nine patients received 325 Carpentier-Edwards biological valves from April 1976 to April 1982. Valves were placed in the following positions: 150 aortic (AVR), 120 mitral (MVR), 26 multiple (MR), 2 pulmonary (PR) and 1 tricuspid (TR). The mean age was 54.7 years. The total follow-up time was 2545 patient-years. Patients were divided into different age groups: less than 40, 40-49, 50-59, 60-69 and greater than 70 years and were followed-up for reoperations and tissue failure. Ninety-three operations were performed in 91 patients (30.5%) for valve related dysfunctions. The main cause of reoperation was primary tissue failure (85%). The respective incidence and risk of reoperation in the different age groups were 51.5% and 5%, 41.5% and 4%, 32% and 3%, 18% and 2.5%, and 0% for greater than 70 years of age. The risk of reoperation decreased significantly with increasing age (P less than 0.05). The respective incidence and risk of tissue failure in the age groups were 43.8% and 4.1%, 35% and 4%, 27.3% and 3.2%, and 17.2%, 2.4% and 0%. The freedom from reoperation and tissue failure was significantly higher in the older patient (greater than 60 years) compared to the younger patients (less than 60 years). The commonest cause of failure in young patients was calcification, while in older patients it was cusp rupture. Comparing aortic and mitral bioprostheses in the different age groups showed no difference between these valves in patients less than 50 years of age.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

Esophagocutaneous drainage to treat late and complicated esophageal perforation.

Five patients with complicated esophageal perforation--three with spontaneous rupture, one with dehiscence after resection of a diverticulum, and one with an iatrogenic lesion--were successfully treated by esophagocutaneous drainage of the esophageal perforation. At thoracotomy, after careful debridement and cleaning of the mediastinum and pleura, a T-tube drain was placed in the esophagus through the perforation in addition to pleural drains. A feeding jejunostomy and a gastrostomy was carried out via a separate laparatomy in 4 cases. Postoperatively the patients were managed according to a protocol with subsequent removal of pleural drains, esophageal T-tube and, after esophageal healing, gastrostomy and feeding jejunostomy. Broad-spectrum antibiotics were given initially. Healing was slow but progressive and without major problems. The healing process was followed by repeated contrast swallows. In all cases the esophagus healed without residual stenosis within 8-12 weeks. This method seems to be a way to save the life and the esophagus of patients with esophageal perforations complicated by late discovery or failure of primary repair.

Aged↗
PubMed1991

Immunohistochemical detection of two small cell lung carcinoma-associated antigens defined by MAbs F12 and 123C3 in bronchoscopy biopsy tissues.

We have studied MAbs* for their ability to detect SCLC and differentiate this tumor type from the other lung tumor histotypes in cryostat sections of biopsy specimens taken at bronchoscopy from patients with suspected primary lung tumor disease. MAb F12, specific for the ganglioside fucosyl-GM1, reacted with 58% of the cases with SCLC (n = 19) and with less than 3% of those with non-SCLC (n = 38). MAb 123C3, specifically reactive with NCAM, reacted with 78% of the SCLC cases (n = 23). With this MAb no positive staining was seen in the non-SCLC cases (n = 41). None of the two MAbs reacted with tissue sections without tumor. In combined analysis with MAbs F12 and 123C3, all SCLC cases (n = 15) were positive with either and 47% with both of the MAbs. Our results show that both MAbs F12 and 123C3 are highly specific for SCLC in bronchoscopic biopsy tissue specimens, whereas the sensitivity for this histotype tends to be higher with MAb 123C3 than with F12 (P = 0.14). When used in combination, all SCLC cases could be identified. These MAbs may therefore be valuable as complements to current histopathologic characterization and differentiation of lung cancer.

Adenocarcinoma, Bronchiolo-Alveolar↗