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Biomedical subjects

T Karlsson

Publications and source records attributed to T Karlsson.

At least 163 records · Page 9Linked to original sources

Postoperative follow-up of patients with colorectal carcinoma by colonoscopy.

OBJECTIVE: To find out if colonoscopy is of use in the follow-up of patients who have been operated on for colorectal carcinoma. DESIGN: Retrospective study. SETTING: Department of diagnostic radiology, university hospital. SUBJECTS: 390 consecutive patients operated on for colorectal carcinoma during the 10-year period 1981 to 1990. MAIN OUTCOME MEASURES: Number of recurrences, synchronous of metachronous tumours, and number and size of adenomas found on colonoscopy. RESULTS: Neoplastic lesions were found in 175 (45%) of the 390 patients studied. There were 14 anastomotic recurrences and 12 new primary carcinomas. At operation for recurrent tumours Dukes' A or B lesions were found in half of the 14 patients who had no symptoms, and a quarter of the 12 who had had symptoms. Those with recurrent carcinoma were younger than those without. Adenomas 1 cm in diameter or more were found in 44 patients and 104 had adenomas less than 1 cm. In addition one carcinoid was found. CONCLUSION: Colonoscopy gave a high yield of neoplastic lesions when used to follow-up patients after resection of colorectal carcinoma, particularly at six months, and resulted in half the recurrent carcinomas being diagnosed before the patients had symptoms. We recommend its use for follow-up of high risk patients, but further studies are needed to establish the optimum time intervals.

Adenoma↗

Serum lipids and lipoproteins in relation to restenosis after coronary angioplasty.

Restenosis after coronary angioplasty (PTCA) is a major problem, limiting the long-term efficacy of the procedure. Lipoprotein levels are associated with the development of atherosclerosis and may also be associated with restenosis. In this study the serum levels of cholesterol (CH), triglycerides (TG), high density lipoprotein (HDL) and low density lipoprotein (LDL) were analysed in 157 patients undergoing 161 PTCA procedures. Follow-up coronary angiograms were performed after 6.0 +/- 4.3 months. The restenosis rate was 33%. Treatment with aspirin and a residual stenosis of 25-49% immediately after successful PTCA were the only variables associated with restenosis (P less than 0.05), otherwise the clinical and angiographic characteristics were similar with and without restenosis. There was no relationship between restenosis and the levels of CH, TG, HDL or LDL (P greater than 0.05). In univariate and multivariate analysis of males (n = 121) and females (n = 40) separately, restenosis was associated with low HDL in men and high HDL in women (P less than 0.05), but not with CH, TG or LDL (P greater than 0.05). We conclude that the serum levels of CH, TG and LDL do not seem to be related to restenosis after PTCA. It is suggested that low HDL in males and high HDL in females is related to restenosis.

Adult↗

Mortality and morbidity 1 year after early thrombolysis in suspected AMI: results from the TEAHAT Study.

We randomized 352 patients with suspected acute myocardial infarction (AMI) to treatment with rt-PA (n = 177) or placebo (n = 175). Patients were eligible if evaluated within 2 h and 45 min from onset of chest pain, and if aged less than 75 years. There were no ECG criteria for inclusion. A mobile coronary-care unit with a cardiologist present was used to initiate treatment at home in 29% of cases. During 1 year of follow-up the mortality in patients treated with rt-PA was 10.2%, as compared with 14.3% in patients the initial ECG, the mortality during the first year was 8% in the rt-PA group vs. 18% in the placebo group (P less than 0.05). Among patients without ST-elevation the mortality was 9% for the rt-PA group vs. 12% for the placebo group (NS). Requirement for rehospitalization, symptoms of angina pectoris and congestive heart failure, time of return to work and requirement for various medications did not differ significantly between the two groups, regardless of the initial ECG pattern.

Aged↗

The prognosis of patients suspected of having acute myocardial infarction subsequent to its exclusion as the diagnosis.

This review of the literature concerns the prognosis of patients suspected of having myocardial infarction subsequent to its exclusion as the diagnosis. Several investigations show a surprisingly bad prognosis for patients in this category, almost comparable to that of patients with a confirmed infarction. When the results of the different studies are pooled, however, there is a significant difference between those patients with true infarction, and those in whom infarction was excluded, in terms of overall mortality (12% and 7%; P less than 0.0001) and the development of subsequent non-fatal infarction (11% and 6%; P less than 0.05) when the results are analysed for a period of follow-up of one year. The difference was significant even when both fatal and non-fatal infarctions were taken into account over the one-year period of follow-up (13% and 8%; P less than 0.0001). The analysis shows that electrocardiographic ST-T changes are a risk factor for coronary events, but the results are conflicting for other possible risk factors. The selection of patients varies between the different studies, which probably contributes to the different results reported. Prospective studies with well defined groups of patients large enough to permit analysis of subgroupings will be needed to resolve the outstanding questions.

Diagnostic Errors↗

Primary structure of a mouse mastocytoma proteoglycan core protein.

The complete nucleotide sequence of a mouse mastocytoma proteoglycan core protein mRNA was determined. The mRNA, estimated to contain 1.1 kb, encodes a protein with an Mr of 16715. A 21-amino acid-residue region of the protein is composed of alternating serine and glycine residues. Southern-blot analysis of mouse genomic DNA with cDNA containing sequences corresponding to the Ser-Gly repeat region revealed more than 15 gene fragments. Hybridization with a probe corresponding to the N-terminal portion of the core protein identified two fragments, and cDNA covering the C-terminal part of the core protein and the 3' untranslated part of the mRNA hybridized to a single fragment. Antibodies against the core protein, obtained after immunization of rabbits with a fusion protein, reacted with both chondroitin sulphate proteoglycans and heparin proteoglycans produced by the tumour. In immunoblotting of a microsomal fraction from the mastocytoma, the antiserum recognized a single protein (Mr 17,000), which probably represents the core protein before glycosylation.

Aggrecans↗

Detection of IgG4 antibodies by immunoblotting in patients on vespid venom immunotherapy.

A nitrocellulose immunoblotting procedure has been used to monitor patient specific IgG antibodies during Hymenoptera vespid venom therapy. By using monoclonal antibodies in the immunoblot assay the relative IgG4 antibody levels could be analysed semiquantitatively. Treatment with vespid venom over 2 years resulted in rises in venom-specific IgG4 antibodies mostly directed towards antigen 5, phospholipase A and hyaluronidase. The use of high quality monoclonal antibodies in immunoblotting assays offers an improvement in the in vitro evaluation of venom immunotherapy.

Animals↗

Memory improvement at different stages of Alzheimer's disease.

Three groups of patients with dementia of the Alzheimer type (mildly, moderately and severely demented) and two groups of healthy older adults (73 and 82 yr old) were examined on free and cued recall of subject-performed tasks (SPTs) or verbally presented sentences depicting the same verbal information as the SPTs. Results indicated that all groups examined performed better on SPTs than on the verbal task. In addition, for all groups cuing effects were greater in the SPT task than in the verbal task.

Aged↗

HIV-related deaths outside medical institutions in Stockholm.

During a 3-year period (August 1st, 1985 to July 31st, 1988) a systematic investigation of medico-legal autopsy cases with regard to the presence of antibodies for HIV-virus was carried out at the Department of Forensic Medicine in Stockholm, Sweden. Prior to autopsy, blood samples were taken from femoral or subclavian veins and were investigated by use of ELISA-screening and Western blotting test. During the first year of study, HIV infection was demonstrated in 11 out of 3464 deaths (0.32%), during the second year in 29 out of 3483 deaths (0.83%), and during the last year in 13 out of 3107 deaths (0.42%). It was shown that 48 out of the total of 53 HIV positive cases were previously registered, but information about the infection was available to the autopsist in only 27 cases. Drug addicts dominated 41 of 53 cases. There were only eight homo- and bisexual males, two non drug addict Central Africans and two persons who received blood transfusions. Eight of the 53 persons died of natural causes whereas 45 deaths were due to violence and drugs. The causes of death of the HIV positive drug addicts were compared to the causes of death of the HIV negative addicts. The HIV positive drug addicts tended to die suddenly in connection with the intravenous administration of heroin and at lower blood concentrations of morphine more often than the HIV-negative addicts. No increase in the suicide frequency was noted in drug addicts in Stockholm during the studied period.

Acquired Immunodeficiency Syndrome↗

Priming and cued recall in elderly, alcohol intoxicated and sleep deprived subjects: a case of functionally similar memory deficits.

Young, old, alcohol intoxicated, and sleep deprived subjects studied weakly and strongly related word pairs, and were tested in lexical decision priming and cued recall. Results showed memory deficits for old, alcohol intoxicated, and sleep deprived subjects in cued recall of weakly related pairs. In contrast, there were no differences between these three groups and a control group of young subjects in cued recall of strongly related pairs, and there were no differences between groups in priming. This pattern of results is interpreted to support (a) a hypothesis of functional similarities between the memory deficits associated with adult ageing, alcohol intoxication, and sleep deprivation; (b) the notion that memory deficits in these subjects are more likely to occur in tasks which require effortful rather than automatic processes; and (c) the view that the memory deficits observed are due to inefficiencies at both encoding and retrieval.

Adult↗

Temperature-dependent interaction between vasoconstrictor and vasodilator mechanisms in human skin.

The putative influence of the thermoregulatory state on skin blood-flow responses to various stimuli was studied in 17 healthy subjects exposed to different ambient temperatures. Skin blood flow was monitored by laser Doppler flowmeters and photoelectrical pulse plethysmographs. Stimuli included painful intraneural electrical stimulation (INS) in the median nerve at the wrist, mental stress, arousal stimuli and deep breaths. Intraneural electrical stimulation and mental stress were accompanied by virtually identical changes in skin blood flow, warm subjects responding with cutaneous vasoconstriction whereas cold subjects responded with vasodilatation. Similar but less pronounced responses were obtained with arousal stimuli and single deep breaths. The data indicate that the thermoregulatory state profoundly influences the extent and direction of various cutaneous vasomotor reflex responses. Furthermore, there were differences between responses in hands and feet, suggesting a spatial organization of vasomotor control.

Adolescent↗

Patterns in sharp force fatalities--a comprehensive forensic medical study: Part 2. Suicidal sharp force injury in the Stockholm area 1972-1984.

A total of 89 cases of sharp force suicide that had been committed in the Stockholm area in Sweden from 1972 through 1984 were investigated. The series showed a male preponderance, sex ratio 3.3, and among males a shift towards the age group 40 to 49 years of age. An impact of cultural/ethnic factors was indicated by the overrepresentation of Finnish and Hungarian immigrants. A psychiatric diagnosis had been ascribed in 22 cases, and addiction to drugs or alcohol in 23. Previous attempts at self-destruction were recorded in 11 cases, only 1 of which was by sharp force. Classical indicators of suicidal intent, for example, suicide notes and the presence of hesitation injuries, were found in 28 and 80%, respectively. A preference for certain anatomical locations (throat, precordium, epigastrium, wrists) was confirmed as was the tendency to expose the skin before inflicting suicidal wounds. As compared to homicidal precordial stabs whose entrance wounds usually run vertically, horizontal or upwards/left-slanting stabs are strongly suggestive of suicide. Although cases were encountered where several "rules of thumb" concerning homicidal versus suicidal patterns were violated, our series contained no case of injuries to the backside of the trunk and no case of more than one wound piercing the left ventricle of the heart. Multiple chest wounds transecting costal or sternal bone were however not uncommon, and, along with the use of bizarre tools and objects like wood chisels or pieces of glass, illustrated the determination of suicidal intent. Toxicological analysis was positive for drugs in 22 and for alcohol in 27 cases. Blood alcohol levels were roughly similar to those found in victims of homicidal sharp force, whereas drug levels tended to be lower or higher in suicides.

Adult↗

Effects of word fragment completion on free recall. A selective improvement of older adults.

Younger adults (mean age 20.7 years), 73-year-olds, and 82-year-olds studied words and words with two missing letters that had to be completed (word fragments) under incidental learning conditions. Results from an unexpected free recall test showed that the 82-year-olds recalled significantly more word fragments than words, whereas the 73-year-olds showed a slight improvement in the same direction. The younger adults, on the other hand, did not benefit from the additional encoding activity of the word fragment completion, although they showed a higher level of recall performance than the elderly groups for both encoding conditions. It is suggested that older adults may need the attentional guidance provided by the problem-solving demands of word fragment completion to perform maximally in this situation, whereas younger adults, because of a superior ability for self-initiated recoding operations, are less dependent on this form of cognitive support.

Adult↗

Patterns of memory performance in young-old and old-old adults: a selective review.

Three experiments were discussed as a means of bridging the gap between biological and psychological data on aging and memory. Memory performances of young-old (73 year-old) and old-old (82 year-old) subjects were compared. The common denominator of these experiments was that contextual or cognitive support had been provided at study and/or test. The rationale behind discussing these experiments in the present context was that subjects should be able to use this support to focus attention on the critical aspects of the to-be-remembered information; thereby the subjects should be able to compensate for neurological degeneration pertinent to attentional difficulties. The nature of the differences between young-old and old-old subjects was found to vary among tasks. Study 1 demonstrated qualitative differences between young-old and old-old subjects, whereas Studies 2 and 3 demonstrated the differences to be merely quantitative in nature. Implications for memory training programs for the elderly were discussed.

Adult↗