The SWEDATE Project: interaction between treatment, client background, and outcome in a one-year follow-up.
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Adult↗
Biomedical subjects
S Lindberg
Publications and source records attributed to S Lindberg.
Cancer risks in thyroid cancer patients.
Cancer risks were studied in 834 thyroid cancer patients given 131I (4,551 MBq, average) and in 1,121 patients treated by other means in Sweden between 1950 and 1975. Record-linkage with the Swedish Cancer Register identified 99 new cancers more than 2 years after 131I therapy [standardised incidence ratio (SIR) = 1.43; 95% confidence interval (CI) 1.17-1.75] vs 122 (SIR = 1.19; 95% CI 0.88-1.42) in patients not receiving 131I. In females treated with 131I overall SIR was 1.45 (95% CI 1.14-1.83) and significantly elevated were noted for tumours of the salivary glands, genital organs, kidney and adrenal gland. No elevated risk of a subsequent breast cancer or leukaemia was noted. SIR did not change over time, arguing against a strong radiation effect of 131I. Organs that were estimated to have received more than 1.0 Gy had together a significantly increased risk of a subsequent cancer following 131I treatment (SIR = 2.59; n = 18). A significant trend was seen for increasing activities of 131I with highest risk for patients exposed to greater than or equal to 3,664 MBq (SIR = 1.80; 95% CI 1.20-2.58). No specific cancer or group of cancers could be convincingly linked to high-dose 131I exposures since SIR did not increase after 10 years of observation. However, upper confidence intervals could not exclude levels of risk that would be predicted based on data from the study of atomic bomb survivors. We conclude that the current practice of extrapolating the effects of high-dose exposures to lower-dose situations is unlikely to seriously underestimate radiation hazards for low LET radiation.
Female↗
Sympathetic nerve stimulation influences mucociliary activity in the rabbit maxillary sinus.
The effect of preganglionic sympathetic nerve stimulation on mucociliary activity in the rabbit maxillary sinus was investigated in vivo. Response to nerve stimulation was recorded photoelectrically and expressed as a percentage of the basal mucociliary activity prior to stimulation. Nerve stimulation (15 V, 5 ms) for 60 s at 2, 10 and 20 Hz stimulated mucociliary activity, the maximum increase being 21.1 +/- 1.3% at 20 Hz, an increase that pretreatment with the cholinergic antagonist atropine reduced to 14.5 +/- 2.4%, suggesting that part of the response involves cholinergic mechanisms. Nerve stimulation (10 Hz) of animals pretreated with the beta-adrenoceptor antagonist propranolol reversed the mucociliary response from an increase to a decrease (-10.6 +/- 1.6%), indicating the involvement of beta-receptors in the nerve-evoked increase. Pretreatment with the alpha-adrenoceptor antagonist phentolamine had no effect on response to nerve stimulation. Rabbits given a combined atropine, propranolol and phentolamine blockade manifested decreased mucociliary activity in response to nerve stimulation (-10.6 +/- 2.1%). Guanethidine pretreatment blocked the effect of nerve stimulation on mucociliary activity, including the observed decrease after combined blockade, indicating the effect to be mediated via sympathetic nerve fibres. The decrease in mucociliary activity in response to nerve stimulation after combined cholinergic-, beta-, and alpha-adrenoceptor blockade suggests the presence of a nonadrenergic, non-cholinergic inhibitory mechanism. It is possible that this effect is mediated by release of neuropeptide Y, as intraarterial injections of neuropeptide Y reduce mucociliary activity in the rabbit maxillary sinus, and as neuropeptide Y is released in the upper airways upon sympathetic nerve stimulation.
Animals↗
Stimulus sequence and the exponent of the power function for loudness.
In two experiments, 15 and 13 subjects estimated the loudness of 12 sound-pressure levels (38-104 dB; 6-dB intervals) of a 1000-Hz tone by the method of magnitude estimation with a modulus assigned to the first stimulus presented. The tone duration was 1 sec. and the interstimulus interval was 6 sec. The presentation order was systematically ascending-descending in one experiment and balanced-irregular in the other. The results indicate that (1) loudness is a power function of sound pressure with an exponent of 0.60 for the systematic order and 0.29 for the irregular order. (2) For both the irregular and systematic orders, a large step-size (12 or 18 dB) between the stimulus on Trial n and on Trial n-1 (or n-3) results in a slight assimilation effect. This also occurs for the small step-size (6 dB) in the irregular order. (3) The size of momentary exponents (based on two points, Trials n and n-1 or n-3) depends on the sound pressures of successive stimuli, whether the steps are positive or negative, and whether the stimuli have been presented in systematic or irregular order. For positive steps, the momentary exponent is lower for a soft tone (Trial n) than for a loud tone, whereas for negative steps the momentary exponent is lower for a loud tone than for a soft tone. These effects ar more pronounced when these stimuli are presented in an irregular order. A relative judgment model is offered for magnitude estimation. It assumes that subjects judge the loudness of a stimulus in terms of three reference markers: the minimum and maximum sound pressures as well as the sound pressure of the previous stimulus.
Adult↗
Tissue kallikrein stimulates mucociliary activity in the rabbit maxillary sinus.
The in vivo effect of tissue kallikrein on the mucociliary activity in the rabbit maxillary sinus was investigated administering the substance (0.1-5 mU/kg) via a. maxillaris and recording the response with a non-invasive photoelectric technique. Tissue kallikrein accelerated mucociliary activity, with a maximum response for the dose 5 mU/kg (33.7 +/- 13.4% from basal levels, n = 5). The effect had a latency of abut 1 min, with a peak within 2-3 min after the beginning of the administration. The response to tissue kallikrein displayed tachyphylaxis with a second dose producing a weaker response. Pretreatment with the protease inhibitor aprotinin (10,000 KIU bolus/kg) inhibited the action of tissue kallikrein. Tissue kallikrein probably stimulates mucociliary activity by producing lysylbradykinin from kininogen. Bradykinin has in an earlier study been shown to stimulate mucociliary activity.
Animals↗
The effect of neuropeptide Y on mucociliary activity in the rabbit maxillary sinus.
The effect of neuropeptide Y (NPY) on mucociliary activity in the rabbit maxillary sinus was investigated in vivo by injecting NPY at increasing dosages into the maxillary artery, response being recorded photoelectrically. At dosages of 0.1-5.0 micrograms/kg, NPY reduced mucociliary activity dose-dependently, the maximum decrease being 14.6 +/- 1.8%, at a dosage of 5.0 micrograms/kg. The NPY-induced reduction of the mucociliary activity manifested brief latency, the peak effect occurring within 3 min followed by a slow return to the baseline value 4-9 min after injection. The response of mucociliary activity to NPY remained unaffected by pretreatment with the alpha-adrenergic antagonists yohimbine (alpha 2) at 100.0 micrograms/kg and phentolamine (alpha 1 + alpha 2) at 0.2-1.0 mg/kg, indicating that the effect of NPY is not mediated via alpha-receptors. Pretreatment with the calcium antagonist nifedipine at 100.0 micrograms/kg inhibited the effect of NPY, suggesting that the NPY-induced decrease may be calcium dependent.
Adrenergic alpha-Antagonists↗
Predictive value of quantitative cisternography in normal pressure hydrocephalus.
Twenty-five patients with normal pressure hydrocephalus (NPH) and 16 patients with cerebral atrophy were investigated by quantitative cisternography using anterior images of the head 3, 6 and 24 h after a lumbar injection of 200 MBq 99mTc DTPA (diethylene-triamine-penta-acetic acid). The activity in the lateral ventricles, basal cisterns, hemispheric convexities and total intracranial region was measured. Ratios between these regions/quantities were calculated. Fifteen of the NPH patients improved while 10 were unchanged after ventriculo-peritoneal shunt surgery. The ratio between ventricular and total intracranial activity (V/T) correlated positively with the degree of improvement after shunt surgery. All NPH patients with a V/T ratio higher than 32% improved after the operation but a V/T ratio less than 32% did not exclude the possibility of improvement. With regard to quantitative measurements, the radionuclide cisternography procedure can be reduced to imaging at 24 h.
Aged↗
Histamine stimulation of mucociliary activity in the rabbit maxillary sinus.
The in vivo effect of histamine on mucociliary activity in the rabbit maxillary sinus was investigated by injecting histamine into the maxillary artery and recording the responses with a photoelectric technique. Histamine stimulated the mucociliary activity dose-dependently in the dose range 10 to 1,000 micrograms/kg. The maximum response was 31.6% +/- 3.7% at a dose of 50 micrograms/kg. The histamine-induced stimulation of the mucociliary activity was characterized by a short latency with a peak response within 1 to 2 minutes and a slow decline lasting about 5 minutes. The response displayed tachyphylaxis. Cholinergic blockade with atropine did not affect the response to histamine. Blockade of H1 receptors with pyrilamine abolished the response to histamine, whereas blockade of H2 receptors with cimetidine was without effect. The H2 agonist dimaprit failed to stimulate the mucociliary activity. It is concluded that histamine stimulates the mucociliary activity in the rabbit maxillary sinus via H1 receptors.
Animals↗
Efficacy expectations among alcohol-dependent patients--a Swedish version of the Situational Confidence Questionnaire.
The Situational Confidence Questionnaire (SCQ) developed by Annis (1986 A relapse prevention model for treatment of alcoholics. In Treating Addictive Behaviors. Processes of Change, Miller W. R. and Heather, N. eds, pp. 407-435. Plenum Press, New York) is an important assessment instrument for use in the treatment of alcoholism and particularly in relapse prevention. The SCQ was translated into Swedish and tested on 91 alcohol-dependent patients. A principal component analysis of the item responses resulted in a shortened 35-item version of the SCQ with satisfactory test-retest reliability, internal consistency and scale specificity. Instead of eight relapse situation categories the analysis resulted in four categories with lower intercorrelations than in the original SCQ. The components were: (1) unpleasant emotions; (2) social pressure; (3) testing personal control; and (4) positive emotional states. In a one-way ANOVA only the Social Pressure scale had a significant relationship with severity of alcohol problems.
Alcoholism↗
[There is no increased risk of thyroid cancer after diagnostic doses of 131I].
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Adult↗
Pulmonary embolism in renal cell carcinoma with vena cava extension.
Of 18 patients with renal cell carcinoma extending into the inferior caval vein, 11 underwent nephrectomy and cavathrombectomy and were examined by pulmonary scintigraphy pre- and postoperatively. In 7 patients, who underwent non-radical surgery or no surgery at all and had died of generalized tumour, the postmortem examination reports were scrutinised. On pulmonary scintigraphy, altogether 6 patients (55%) were free from perfusion defects preoperatively. Between the pre- and postoperative examination, perfusion defects appeared, disappeared, varied in size or were unchanged. Only 4 patients (36%) had acquired new defects. The total number of defects preoperatively was 14 and postoperatively 12. Most defects engaged less than a pulmonary segment and only 2 a whole segment. None gave clinical symptoms. No macroscopic pulmonary emboli were found in any patient at the postmortem examination.
Carcinoma, Renal Cell↗
Mortality among male and female hospitalized alcoholics in Stockholm 1962-1983.
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Adolescent↗
VIP potentiates cholinergic effects on the mucociliary system in the maxillary sinus.
The neuropeptide vasoactive intestinal polypeptide (VIP), which is found in a population of cholinergic parasympathetic neurons in the airways, has no effects per se on mucociliary activity. In order to test the hypothesis that VIP may modulate cholinergic regulation of the mucociliary system, VIP was infused intraarterially (8.4 pmol/kg/min), and the response to challenges with methacholine in the maxillary sinus of rabbits were recorded with a photoelectric technique. Occurrence of VIP-like immunoreactivity in the rabbit maxillary sinus, maxillary nerve, and sphenopalatine ganglion was investigated. Immunoreactivity against VIP was found in nerve fibers in the subepithelial layer of the maxillary sinus and in numerous nerve cell bodies in the sphenopalatine ganglion. Infusion of VIP potentiated the mucociliary increase induced by methacholine. The mucociliary wave frequency change increased from 6.1% +/- 1.7% to 13.3% +/- 3.9% (0.01 micrograms/kg methacholine), from 11.6% +/- 3.6% to 18.8% +/- 2.2% (0.05 micrograms/kg) and from 17.0% +/- 3.0% to 27.4% +/- 3.6% (0.1 micrograms/kg). Both peak responses and response durations increased during infusions. In contrast, the vasodilating agent papaverine sulphate did not influence the mucociliary response to methacholine. The modulating effect of VIP on the mucociliary system, taken together with the morphologic observations, suggest that VIP may have a physiologic role in the regulation of the mucociliary system in the maxillary sinus.
Animals↗
Early diagnosis of and surgical strategy for adrenal medullary disease in MEN II gene carriers.
Sixteen multiple endocrine neoplasia type II (MEN II) gene carriers--12 who had undergone thyroidectomy because of medullary carcinoma of the thyroid and 4 whose thyroid glands had been removed because of C cell hyperplasia--were examined for the presence of pheochromocytomas. No patient had sought medical advice for pheochromocytoma symptoms. Fourteen patients had MEN IIa syndromes, one patient had a MEN IIb and another patient had a mixed syndrome of von Recklinghausen's neurofibromatosis and MEN II. Eight patients had undergone unilateral adrenalectomy for pheochromocytoma 11 +/- 4 years before. The patients underwent clinical examination, determination of the urinary excretion of catecholamines and metabolites, and 131I-metaiodobenzylguanidine (131I-MIBG) and CAT scans. 131I-MIBG scanning was performed with images 1, 4, and 7 days after the radionuclide injection. In seven of eight patients who had undergone unilateral adrenalectomies, the 131I-MIBG scans showed accumulation of the radionuclide in the remaining adrenal gland. Bilateral adrenal accumulation of the radionuclide was demonstrated in seven of eight MEN IIa gene carriers who had not undergone adrenalectomy. Five patients, two of whom had undergone adrenalectomy, were found to have unilateral pheochromocytomas less than 2 cm in diameter. Only one of these five patients had an elevated excretion of urinary catecholamines. Between day 4 and day 7 after 131I-MIBG injection, adrenal glands with pheochromocytomas increased their relative accumulation of the radionuclide significantly more (p less than 0.02) than did adrenal glands without any demonstrable pheochromocytomas. All the pheochromocytomas were viewed by means of CAT scans. Only one MEN IIa patient had bilateral pheochromocytomas, but our findings indicate that there is a tendency to bilateral adrenal medullary hyperfunction in most MEN II gene carriers. As 131I-MIBG and CAT scans can facilitate the early diagnosis of pheochromocytomas, unilateral adrenalectomy can safely be performed in most MEN IIa patients. Bilateral pheochromocytomas develop in a majority of patients with MEN IIb syndromes. Bilateral adrenalectomy should therefore be performed in these patients.
3-Iodobenzylguanidine↗
Methodology and dosimetry in adrenal medullary imaging with iodine-131 MIBG.
Iodine-131 MIBG scans were performed in 59 patients in order to localize intra- or extra-adrenal pheochromocytomas (pheos), or to visualize hyperplastic adrenal medulla. Images were obtained from the pelvis to the base of the skull on Days 1, 4, and 7 after tracer injection. The 15 patients with histopathologic confirmation of adrenal medullary disease had positive scans. In three of these, the pheos were visible only on images obtained on Day 7. One scan was false negative. After excluding patients with a predisposition to adrenal medullary disease, nine subjects (28%) without verification of pheo displayed adrenal uptake of the radionuclide. Late images produce a low rate of false-negative scans; the background activity diminishes and even small pheos can be detected. In order to increase the quality of late images, 40 MBq [131I]MIBG was used instead of 20 MBq. The dosimetric considerations are discussed.
3-Iodobenzylguanidine↗
The relation between drinking habits and neuroticism and weak ego among male and female alcoholic patients.
The relationship between drinking habits and personality functioning was studied in a consecutive series of 300 alcoholic inpatients during treatment and 2 1/2 years later. The alcoholic sample showed more signs of neuroticism and lack of ego strength than the general population. Among the alcoholics there was a relationship between advanced drinking habits and more pathological personality functioning. However at the follow-up improved drinking habits were connected only with improved self-esteem, particularly among female patients.
Adult↗
Stimulation of C fibers by ammonia vapor triggers mucociliary defense reflex.
The neuropeptide substance P (SP) released from airway sensory C fibers accelerates mucociliary activity, and C fibers in the airways are stimulated by various irritants including ammonia (NH3) vapor. The short-term effects of NH3 vapor on mucociliary function in the in the maxillary sinus of rabbits anesthetized with urethane were investigated by a photoelectric technique. Challenges with 1.5 ml NH3 increased mucociliary activity dose-dependently, the maximal response being 26.6 +/- 1.6%. The increase appeared within 1.3 +/- 0.3 s after exposure. Atropine and hexamethonium decreased the effect of NH3, indicating that part of the response was mediated by cholinergic effector neurons, but a noncholinergic effect clearly remained. Pretreatment with large doses of capsaicin (13 mg i.a.) abolished the response, whereas the SP antagonist (D-Pro2, D-Trp7,9) SP inhibited the noncholinergic response. Challenges with NH3 vapor also decreased the respiratory rate. An identical response was noticed during injections with the C fiber stimulant capsaicin. Together these results indicate that NH3 vapor triggers a mucociliary protective reflex in the airways, involving capsaicin-sensitive C fibers. The recorded increase of mucociliary activity is probably due to the combined effect on the mucociliary system of both SP and acetylcholine released from the afferent and efferent part of the reflex arc, respectively.
Ammonia↗
The role of neurokinin A and calcitonin gene-related peptide in the mucociliary defence of the rabbit maxillary sinus.
Substance P (SP) released from sensory C-fibres in the airways increases the mucociliary (m.c.) activity in the rabbit maxillary sinus. The purpose of the present study was to investigate the m.c. effects of two other neuropeptides, coexisting with SP in sensory neurones, neurokinin A (NKA) and calcitonin gene-related peptide (CGRP). NKA increased the m.c. activity dose-dependently (dose range 0.1-5.0 micrograms/kg) the maximum increase being 33.6 +/- 6.0%. The effect was inhibited by pretreatment with the tachykinin antagonist (D-Pro2, D-Trp7,9)SP, but not with atropine or hexamethonium. Thus NKA released from sensory C-fibres may contribute to the non-cholinergic increase of m.c. activity observed after C-fibre stimulation. In contrast CGRP did not influence the m.c. activity. Neither did it influence the responses to NKA or SP. It is concluded that CGRP is unlikely to be involved in the control of m.c. function.
Animals↗