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Biomedical subjects

S Larsson

Publications and source records attributed to S Larsson.

At least 163 records · Page 9Linked to original sources
PubMed1995

Does the Wilms' tumour suppressor gene, WT1, play roles in both splicing and transcription?

The Wilms' tumour suppressor gene (WT1) encodes a protein(s) with 4 zinc fingers that is essential for the development of the genitourinary system. A considerable body of evidence exists to support the idea that WT1 binds DNA and functions as a transcription factor. However, we have shown recently by confocal microscopy and immunoprecipitation studies that a significant proportion of WT1 is associated with splice factors in kidney cell lines, fetal tissues and transfected Cos cells. Different isoforms of WT1 are produced by an alternative splice that leads to the presence or absence of a 3 amino acid insertion (KTS) between zinc fingers 3 and 4. We have shown that these different forms localise differently in the nucleus. The +KTS form mainly localises with splice factors, the -KTS form mainly with transcription factors. Here we propose a model to account for these different localisations. Also, we discuss the possible significance of these findings.

Amino Acid Sequence↗
PubMed1995

Bone and wound fluid concentrations of cephalosporins. Oral cefadroxil and parenteral cefuroxime compared in 52 patients with a trochanteric fracture.

We performed a prospective and randomized study in 52 patients to compare the concentrations in cancellous bone and wound fluid of antibiotics, given orally (cefadroxil) or intravenously (cefuroxime) as prophylaxis in trochanteric fracture surgery. Oral cefadroxil resulted in adequate antibiotic levels in 22 of 26 patients in wound fluid and cancellous bone, while parenteral cefuroxime resulted in sufficient antibiotic levels in all 26 patients. The concentrations in bone varied greatly between the subjects.

Administration, Oral↗
PubMed1995

Epidemiology of scapular fractures. Incidence and classification of 338 fractures.

We have studied scapular fractures, with special reference to intraarticular glenoid fractures, during a 10-year period in 2 Swedish counties. There were 338 scapular fractures in 322 patients. The annual incidence was 10/10(5) inhabitants, of which 30 percent affected the glenoid cavity. Out of 100 intraarticular glenoid fractures, 55 occurred in men and 45 in women. The mean age of the women at the time of fracture (64 years) was significantly higher than the mean age of men (49 years). The most common intraarticular glenoid fracture type was the anterior chip fragment fracture which, in about two-thirds of the cases, was associated with shoulder dislocation.

Adult↗
PubMed1995

Infected tibial nonunion. Good results after open cancellous bone grafting in 37 cases.

We treated 37 infected tibial shaft nonunions by debridement followed by open autogenous cancellous bone grafting in a 2-stage procedure. Additional surgery was done in 21 fractures including second debridement before bone grafting and/or a second limited bone grafting and/or a split-thickness skin grafting. All fractures healed after an average of 11 (8-16) months. During 2 years follow-up there were no recurrences of the infection. Two cases of early refracture occurred, both healed following new bone grafting.

Adult↗
PubMed1995

Similar quality of life after heart valve replacement with mechanical or bioprosthetic valves.

The goal of this study was to determine if there was a difference in the quality of life (QoL) between patients receiving bioprosthetic (Biocor, BIO) or mechanical (St. Jude Medical, SJM) valve prosthesis. In January 1993 we assessed the psychological outcome of heart valve surgery among 183 (87 BIO, 96 SJM) of 220 survivors in a selected and matched cohort of 140 BIO and 140 SJM recipients who had their valve replacement between 1983 and 1989. The BIO and SJM groups were equal in terms of mean age, gender, valve position, educational level, marital status and follow up time. Questions concerning QoL, in terms of coping capacity, social support, and general emotional status as well as emotions concerning valve-related complications, were answered by the patients marking a non-graded visual analogous scale, ranging from total agreement to total disagreement. We found no significant difference between patients receiving BIO and those receiving SJM prostheses regarding coping capacity (62 +/- 2 vs. 65 +/- 2), social support (77 +/- 3 vs. 76 +/- 2), or emotional status (63 +/- 3 vs. 65 +/- 3). When subdividing patients by age below and above 60 years, gender, functional class, valve position and complication, we found several significant differences, but the two prosthetic groups were largely similar. Females had a significantly lower level of coping capacity and emotional status than males. Coping capacity and emotional status were significantly correlated with functional class, while social support was not. Coping capacity tended to be lower among patients who had experienced complications and this was more pronounced with BIO.(ABSTRACT TRUNCATED AT 250 WORDS)

Activities of Daily Living↗
PubMed1995

10-year experience with the Biocor porcine bioprosthesis in the mitral position.

One hundred and thirty-seven consecutive patients had mitral valve replacement between January 1983 and January 1993 with Bicor porcine bioprosthesis. Concomitant cardiac procedures were performed in 37% (51/137). Mean age was 63 years. Follow up was 98% complete at a mean of 53 months. Early mortality was 13% (18/137). Within the 10-year follow up another 34 patients died, 21 due to cardiac and three to valve related causes. Overall survival at 10 years as 54.7 +/- 4.9%, and freedom from valve related mortality 94.9 +/- 2.8%. Functional class improved in all surviving patients with 84% being in NYHA class I or II at the end of the tenth year. There were 10 reoperations, three for structural valve deterioration (SVD), three for non-structural valve dysfunction (non-SVD) and four because of prosthetic valve endocarditis (PVE). Actuarial freedom from reoperation for all causes was 78.9 +/- 9.2%. None of the patients were on long term anticoagulation at hospital discharge but 57% received chronic anticoagulant treatment at the end of the 10-year follow up. Embolism occurred in 13 patients (2.5%/pty, fatal 0.4%/pty). Three patients had anticoagulant related hemorrhage (0.6%/pty, fatal 0.2%/pty). Doppler echocardiography was carried out in 52% within the last three years of follow up. Actuarial freedom from SVD (confirmed at reoperation or by echocardiography) was 80.3 +/- 9.8%. At 10 years 93.2 +/- 2.8% were free from PVE. The incidence of total mortality and morbidity was 5.9%/pty (fatal 0.8%/pty) with an actuarial freedom of 59.6 +/- 8.8% from all valve related complications.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Describing the size of lumbar disc herniations using computed tomography. A comparison of different size index calculations and their relation to sciatica.

STUDY DESIGN: The study compared different methods to measure the absolute and relative size of lumbar disc herniations on computed tomography scans and their relation to sciatica. METHODS: Computed tomography (CT) examinations were done before and at 3 and 24 months after nonoperative treatment in 30 patients with lumbar disc herniations. The size of the herniation was described by different indexes and related to the degree of sciatica. One index was formed by the area of the herniation in relation to the spinal canal (A-index), whereas two indexes were formed by linear measurements of the herniation in relation to the spinal canal in either two (ST-index) or one direction (S-index). RESULTS: Each index was correlated significantly to the degree of sciatica. The area of the herniations decreased markedly over time. CONCLUSIONS: Linear measurements of the herniation in two perpendicular directions provide a practical and accurate way of describing the size of lumbar disc herniations.

Adult↗
PubMed1994

Reduced beta 2-microglobulin mRNA levels in transgenic mice expressing a designed hammerhead ribozyme.

We have generated three artificial hammerhead ribozymes, denoted 'Rz-b', 'Rz-c' and 'Rz-d', with different specificities for exon II of the mouse beta-2-microglobulin (beta 2M) mRNA. In this study we tested for ribozyme mediated reduction of beta 2M mRNA in a cell line and in transgenic mice. Transfections of either of the Rz-b, Rz-c or Rz-d plasmids into a mouse cell-line (NIH/3T3) revealed reductions of beta 2M mRNA substrate in each case. Ribozyme expression in individual transfected clones was accompanied with an up to 80% reduction of beta 2M mRNA levels. Rz-c was selected for a transgenic study. Seven Rz-c transgenic founder animals were identified from which three ribozyme expressing families were established and analysed. Expression of the ribozyme transgene was tested for and detected in lung, kidney and spleen. Expression was accompanied with reduction of the beta 2M mRNA levels of heterozygous (Rz+/-) animals compared to non-transgenic litter mates. The effect was most pronounced in lung with more than 90% beta 2M mRNA reduction in individual mice. In summary, expression of our ribozymes in a cell free system, in a cell-line and in transgenic mice were all accompanied with reductions of beta 2M mRNA levels.

3T3 Cells↗
PubMed1994

Quality of life of patients treated by home mechanical ventilation due to restrictive ventilatory disorders.

The quality of life of patients with hypoventilation and home mechanical ventilation (HMV) has not been well described. Modern quality of life assessment techniques were therefore introduced in a cross-sectional study of patients treated with HMV. The aim was to study various aspects of the patient's quality of life and relate them to the underlying diseases, blood gases and the type of ventilatory connection. The study comprised 39 patients, most of them ventilated only during the night (n = 35). Nasal ventilation predominated (n = 29). Patients treated with HMV reported satisfactory levels of both psychosocial functioning and mental well-being that compared well with a general population group. Their quality of sleep was generally good. The quality of life measures were mainly influenced by the patients' underlying disease. Patients with scoliosis expressed in almost all instances the best quality of life. The quality of life of patients with ventilation by tracheostomy was reported to be at least as good as that of patients with nasal ventilation. The global quality of life estimation was mainly determined by the mental state of the patients and their sleep quality and only to a minor extent by physical handicaps. In conclusion, the patients treated with HMV reported good psychosocial functioning and mental well-being, in spite of severe physical limitations and dependence on regular nocturnal ventilation.

Adolescent↗
PubMed1994

Involvement of maternity and health care staff in breast-feeding.

The prerequisites of the staff for their interest and concern in working with questions related to breast-feeding have been studied by questionnaires which were answered by 133 nurses at pregnancy care centres, child health centres and maternity wards. The intention was to identify possible obstacles for the staff in supporting the mother's breast-feeding. In spite of extensive experience and positive attitudes to breast-feeding, about half of the staff found it difficult to work with these questions and to give enough support. The most common reasons for this fact were insufficient knowledge about breast-feeding, few possibilities for further training and a heavy workload. It was also evident that some routines need to be corrected. For instance, information about breast-feeding was provided late during pregnancy, the fathers were infrequently engaged and the communication between the departments was limited. A reorganization of the staff's working routines and their continuous further training in issues related to breast-feeding are recommended.

Adult↗
PubMed1994

Demonstration of dilatation of peripheral airways.

To investigate the ability of various lung-function tests to demonstrate dilatation of peripheral airways, ten asthmatics inhaled increasing doses of a beta 2-agonist by two different and controlled techniques. Low inspiratory flow with a long post-inspiratory pause favoured peripheral deposition, and a high inspiratory flow with a short post-inspiratory pause favoured central deposition of drug in the airways. Ordinary spirometry, maximum expiratory flow rates after breathing air as well as a helium-oxygen mixture, a single breath N2-test and resistance of the respiratory system were obtained before and after each of five terbutaline doses with both inhalation techniques. By using a double-dummy technique, the study could be performed double blinded. Effects were compared at doses giving equal effects on PEF, assumed to represent equal deposition of bronchodilator and effects on central airways. At such 'iso delta PEF doses', particularly FVC and the slope of phase III of the N2-test improved more following the slow inhalation technique. It is concluded that changes in those tests reflect dilatation in peripheral airways in asthmatics.

Administration, Inhalation↗
PubMed1994

The intrabronchial microbial flora in chronic bronchitis patients: a target for N-acetylcysteine therapy?

Chronic bronchitis is common among smokers, often together with recurrent infectious exacerbations. Streptococcus pneumoniae and Haemophilus influenzae are the pathogens traditionally considered most important. N-acetylcysteine (NAC) treatment has been shown to reduce the number of infectious exacerbations in patients with chronic bronchitis. The mechanism behind this is unknown. We attempted to characterize the intrabronchial bacterial flora in patients with chronic bronchitis in an infection-free interval, and to determine whether pharmacological and immunological factors effected the bacterial occurrence. Twenty two smokers with non-obstructive chronic bronchitis, 19 smokers with chronic bronchitis and chronic obstructive pulmonary disease (COPD) and 14 healthy nonsmokers underwent bronchoscopy. To obtain uncontaminated intrabronchial samples, a protected specimen brush was used. Quantitative bacterial cultures and virus isolations were performed. Significantly positive bacterial cultures (> 1,000 colony-forming units (cfu).ml-1) were found only in the patients. S. pneumoniae and H. influenzae were found in five patients, and only in the patients without NAC treatment. The most common bacterium was alpha-haemolytic streptococcus. Negative cultures were more common in the healthy controls. Of the various factors examined, only NAC medication had an influence on bacterial numbers. Significantly fewer patients with NAC medication had positive cultures (3 out of 16) than in the group of patients without NAC therapy (15 out of 21). Our results confirm that chronic bronchitis in smokers leads to increased intrabronchial bacterial colonization. We could also confirm that 1,000 cfu.ml-1 is an adequate cut-off level for significant bacterial growth when using the protected specimen brush. NAC medication was associated with low bacterial numbers.

Acetylcysteine↗
PubMed1994

Circulating cell adhesion molecules in bronchial lavage and serum in COPD patients with chronic bronchitis.

The initial phase of inflammation in bronchial asthma appears to be triggered by the expression of leucocyte-endothelial adhesion molecules on endothelial cell surfaces. Cell adhesion molecules (CAMs) cause adhesion of leucocytes to the endothelium prior to their subsequent extravasation into inflamed tissue. We wanted to determine whether circulating intercellular adhesion molecule-1 (cICAM-1) and circulating E-selectin (cE-selectin) could be detected in bronchial lavage fluid and serum in patients with stable chronic obstructive pulmonary disease (COPD) and chronic bronchitis. Bronchoscopy and small volume bronchial lavage was performed in 19 patients with COPD and chronic bronchitis and in 13 control subjects. We found increased mean levels of cICAM-1 both in serum (481 micrograms.l-1) and in bronchial lavage (24 micrograms.l-1) in the COPD patients as compared to the controls (321 micrograms.l-1 in serum, 15 micrograms.l-1 in lavage). We also found higher mean levels of cE-selectin in serum from the COPD patients (86 micrograms.l-1) compared to controls (50 micrograms.l-1). The serum levels of cE-selectin correlated significantly with lung function measured as forced expiratory volume in one second (FEV1) in percentage of predicted. Patients with significant intrabronchial bacterial colonization had increased levels of serum cE-selectin. Our results indicate that cCAMs may reflect an upregulation of CAMs on endothelial and epithelial airway cells in COPD.

Bronchitis↗
PubMed1994

Bacterial adhesion to oropharyngeal and bronchial epithelial cells in smokers with chronic bronchitis and in healthy nonsmokers.

Bacterial adhesion is probably a prerequisite for colonization of mucous membranes, but adhesion to the bronchial mucosa has not been studied in detail. We investigated adhesion of respiratory pathogens to bronchial epithelial cells, and asked whether chronic bronchitis had an influence on bacterial adhesion. Oropharyngeal and bronchial cells were collected during bronchoscopy from 14 healthy nonsmokers, 22 smokers with nonobstructive chronic bronchitis, and 19 smokers with chronic bronchitis and chronic obstructive pulmonary disease (COPD). Patients with a forced expiratory volume in one second (FEV1) less than 50% predicted were excluded. Adhesion of highly adherent test strains of H. influenzae and S. pneumoniae to these cells were studied. The test strains of H. influenzae and S. pneumoniae were found to adhere well to both oropharyngeal and bronchial cells. H. influenzae showed a higher degree of adhesion both to ciliated and goblet cells from the patients with nonobstructive bronchitis than to cells from the healthy nonsmokers. No corresponding difference was found for S. pneumoniae. The patients with COPD did not differ from the controls in their adhesion values. Our results indicate that bacterial adhesion is of importance for the colonization and retention of H. influenzae in the human airways. For S. pneumoniae the role of adhesion is more uncertain.

Adult↗
PubMed1994

Social pharmacology: unresolved critical issues.

This article describes and analyzes decision-making by patients, physicians, and drug information providers about registered medical drugs. Based on a cognitive psychology perspective, cognitive variables (the individual's mediating system) are assumed to be critical factors determining both patient and physician behavior. The individual's psychological functioning is seen as a continuous reciprocal interaction between behavioral, cognitive, and environmental influences; i.e., an interactional paradigm is applied. The importance of research models including cognitive and situation variables to guide the search for appropriate research methods is stressed. An intensive research strategy with a small sample of respondents will often be necessary. Also, respondents should be asked to describe their reactions to specific medical situations. The drug information sender has to select a set of goals for disseminating information to patients. Among the goals most often selected are: message comprehension, receiver satisfaction, changes in knowledge, attitudes, and drug behavior, as well as health effects. More research is needed on how the patient's mediating system, the actual situation, and the perceived situation steer his search for the use of new drug information. A different set of factors influence the patient's decision to start a medicinal or drug treatment than the factors that influence his decision to continue a treatment. The latter factors include forgetfulness, misunderstandings, and the patient's interpretation of physiological signs. More cognitive-oriented research about drug compliance must be undertaken. In such studies the mediating systems of a group of patients could be considered before and after intervention. There are a great number of types of inappropriate (irrational) prescribing. However, a physician may prescribe rationally in one area but irrationally in another. Face-to-face education of physicians has been shown to be effective in reducing inappropriate prescribing in a number of studies. "Overprescribing" of benzodiazepine has been an issue of intensive professional debate during the last decades. The two groups who criticize and defend the existing use of benzodiazepines build their views on different assumptions about the interaction between mind and brain as well as making different value assumptions regarding the use of a psychotropic drug. There is a need for prescription studies where a cognitive and interactional perspective is combined with an information-processing and a normative perspective. The benzodiazepines dependency problem has provoked lively discussion among professionals and the general public. Long-term benzodiazepine use and personality disorders increase the risk of the patient becoming dependent. A great number of research models have been suggested for the analysis of prescription drug dependency and as guides to the treatment of dependency.(ABSTRACT TRUNCATED AT 400 WORDS)

Benzodiazepines↗
PubMed1994

Mechanical performance of the Monticelli-Spinelli external fixation system.

Six configurations of the Monticelli-Spinelli external fixator were tested for axial compression, bending, and torsion. The ring wire clamp unit was separately tested under repeated cyclic loading and retightening of the clampnuts. The configurations studied were the following: 3 standard (4-ring and 3-ring with 5-mm between the wires and 3-ring with 40 mm between the wires); and 3 hybrid (3-ring and 1 pin, and 2-ring and 2 pins with the rings either placed closer or distant to the fracture). For each configuration, 5 frames were constructed. Axial stiffness was nonlinear for both fixator types. Four-ring fixators and 2-ring 2-pin fixators had similar stiffness, yet were stiffer than 3-ring configurations. Anteroposterior bending stiffness was highest in the 4-ring configurations, whereas oblique bending for standard fixators was similar to lateral bending stiffness for the hybrid configurations. Torsion was higher in the 4-ring construction and in hybrid frames compared to the standard 3-ring frames. For the ring wire clamp unit, stiffness increased and hysteresis diminished after each retightening of the clampnuts because of the increase of contact between clamps and ring. The hybrid configurations provide an alternative that enables more simple configurations with less transfixing elements and sufficient stiffness.

Orthopedic Equipment↗