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PubMed2005

Pedal symphalangism in modern American and Japanese skeletons.

Pedal symphalangism is a surprisingly common heritable trait of the human foot. In individuals exhibiting the trait, the joint between the intermediate and distal phalanges of one or more lateral toes never develops, resulting in toes with two phalanges rather than three. This study was undertaken to explore variation in the frequency of pedal symphalangism among groups with widely different geographic ancestry, and to consider the applicability of this trait to skeletal biological distance studies. A total of 460 Euro-American, 191 African-American and 99 Japanese skeletons were examined for presence of pedal symphalangism. The American individuals date to the first half of the 20th c, while the Japanese individuals date to the late 19th and early 20th c. Although the country of ancestry is unknown for most of the American individuals, the Euro-Americans appear to be largely northern European, with roots in Germany, Ireland and Scandinavia, while the African-Americans are primarily descendants of slaves with roots in west African countries such as Nigeria, Benin, Togo, Ghana and Sierra Leone. Frequencies of fifth toe pedal symphalangism were calculated and compared among all three samples and found to be significantly higher in modern Japanese (83.7%) than in either Euro-Americans (46.4%) or African-Americans (44.0%). The Euro- and African-American frequencies were statistically indistinguishable for symphalangism of the fifth toe. In the fourth toe, however, the opposite result was found. The African-American frequency (7.9%) was significantly higher than the Euro-American frequency (2.6%), while no difference was found between the African-Americans and Japanese (11.7%). Since fourth toe pedal symphalangism has never been observed in the absence of fifth toe involvement, some of the same genes are clearly involved in producing the trait in both toes. However, differences in the pattern of fourth and fifth toe expression among the three groups identified in this study suggest that additional genetic or developmental factors may play a role in expression of pedal symphalangism in each of the toes.

Adult↗

PubMed2006

Postoperative ureteral obstruction after subureteral injection of dextranomer/hyaluronic Acid copolymer.

PURPOSE: Subureteral injection of dextranomer/hyaluronic acid copolymer is widely accepted for the treatment of primary vesicoureteral reflux. Few studies document the incidence of surgically relevant postoperative obstruction or the characteristics of patients at risk. MATERIALS AND METHODS: Four institutions had reported surgically relevant postoperative obstruction to representatives of Q-Med Scandinavia, the manufacturers of Deflux (dextranomer/hyaluronic acid). All children undergoing dextranomer/hyaluronic acid injection at these institutions were evaluated in this study. Patients requiring postoperative stenting were retrospectively reviewed for pertinent history, volume injected, technique of injection, duration of symptoms before intervention, duration of intervention and final outcome. RESULTS: A total of 745 patients (1,155 ureters) underwent injection. Five patients (6 renal units, 7 ureters) required stenting for obstructive symptoms and hydronephrosis, of whom 4 immediately became symptomatic. All patients had been injected with up to 1 ml dextranomer/hyaluronic acid. Four patients (80%) had either a neurogenic bladder or dysfunctional voiding. All stents were placed and removed without complications, with complete resolution of symptoms in all patients. Length of stenting ranged from 2 to 6 weeks. No patient required open surgery. One of 2 patients undergoing postoperative voiding studies had development of recurrent vesicoureteral reflux. CONCLUSIONS: Dextranomer/hyaluronic acid injection is associated with a small risk of postoperative ureteral obstruction requiring endoscopic intervention, with an overall incidence of less than 0.7% of patients injected. Patients with voiding dysfunction or neurogenic bladder may be at increased risk. Intervention with temporary ureteral stenting is effective, technically simple and curative.

Adolescent↗

PubMed2005

Epidemiology of the most frequent diseases in the European a-symptomatic post-menopausal women. Is there any difference between Ireland and the rest of Europe?

Osteoporosis, cardiovascular disease, breast cancer and genitourinary diseases are some of the most frequently diagnosed diseases in a-symptomatic post-menopausal women. There is a marked European geographic distribution of osteoporosis. Rates are higher in Scandinavia than in the Southern European countries. The possible reasons for this higher incidence of osteoporotic fractures in the Northern European countries is associated with the climate, which limits physical activity and exposure to sunlight and increases the risk of falls. During the next two decades, the number of hip fractures for European women over 65 years is expected to nearly double. Despite these figures, osteoporosis prevention has not yet been adopted in many European countries. There is a devastating impact and a huge financial burden on the European economy and health care system. Breast cancer is the most common cancer in females in Europe. The regions of highest incidence are Western and Northern Europe, while Southern and Eastern Europe have lower incidence rates. The causes of differences in breast cancer incidences between Northern and Southern Europe are not known, but the average 5-year survival of women with breast cancer has increased in Europe in the last three decades. Studies have revealed marked differences in cardiovascular diseases across Europe, showing cardiovascular death rates as highest among the Eastern and Central European countries and lowest in the Mediterranean countries. Cardiovascular disease is the major cause of mortality in European women. However, in North European countries, there are more ischaemic heart diseases in women than in Mediterranean countries. In Mediterranean countries, on the other hand, there are more strokes than in Northern Europe. These strokes events occur 10 years later than the ischaemic heart attacks.

Breast Neoplasms↗

PubMed2004

Three-year follow-up of feedback microwave thermotherapy versus TURP for clinical BPH: a prospective randomized multicenter study.

OBJECTIVES: To compare, in a prospective randomized multicenter study, the efficacy and safety of transurethral microwave thermotherapy with ProstaLund Feedback Treatment (PLFT), using the CoreTherm device, with transurethral resection of the prostate (TURP) 36 months after treatment. METHODS: The study was conducted at 10 centers in the United States and Scandinavia. A total of 154 patients with benign prostatic hyperplasia were randomized to PLFT or TURP in a 2:1 ratio. The treatment outcome was evaluated on the basis of the International Prostate Symptom Score (IPSS), the quality-of-life question (QOL) of the IPSS, peak urinary flow rate (Qmax), urodynamics, and adverse events. The microwave power and treatment time were adjusted according to each patient's response to the supplied energy (ie, the intraprostatic temperature guided the PLFT). RESULTS: Statistically significant improvements in both the TURP and the PLFT groups were observed for IPSS, QOL, and Qmax at 36 months. The average value for the PLFT group was 8.2, 1.2, and 11.9 mL/s for IPSS, QOL, and Qmax, respectively. The corresponding values for the TURP group were IPSS 5.0, QOL 1.0, and Qmax 13.5 mL/s. The difference in IPSS outcome was statistically significant; however, no statistically significant differences were found in QOL or Qmax between the two treatment groups. The degree of improvement was in the same range as that observed after 12 and 24 months for both groups. During the 12 to 36-month period, the most frequent adverse events in the TURP group were impotence (15%), micturition urgency (13%), and urethral disorder (8%); in the PLFT group, impotence (8%), prostate-specific antigen increase (5%), and hematuria (4%) were the most common. CONCLUSIONS: The clinical outcome 3 years after microwave thermotherapy with PLFT was comparable to the results seen after TURP. The safety of PLFT compared favorably to that of TURP in this study.

Erectile Dysfunction↗

PubMed2006

Reindeer as hosts for nematode parasites of sheep and cattle.

The reindeer husbandry range of Scandinavia overlaps with sheep, goat, and cattle pastures. The aim of this study was to determine whether reindeer are suitable hosts for ovine or bovine nematode parasites, and thus may spread these parasites into the reindeer husbandry regions. To render worm-free, twelve 4-month-old male reindeer calves, six lambs, and six bovine calves were given ivermectin at 200 microg/kg body weight. Five weeks post-treatment, six reindeer calves were each artificially dosed with 10,000 third-stage larvae (L3) of gastrointestinal nematodes derived from sheep, and an additional six reindeer with L3 derived from cattle. Lambs and bovine calves received the same dose of ovine and bovine larvae as reindeer, from the same larval source, respectively. Faecal samples collected on five occasions after the larval dosing revealed that by the fourth week, all reindeer calves, lambs, and bovine calves were infected. Animals were slaughtered on days 40 (reindeer) or 47 (lambs and bovine calves) after the larval dosing. Reindeer calves were most susceptible to L3 derived from sheep. The overall mean intensity of Haemochus contortus, Trichostrongylus axei, and Teladorsagia circumcincta, did not differ between reindeer and sheep; however, early fourth-stage larvae of H. contortus were more abundant in reindeer (p = 0.002). The establishment of bovine-derived Ostertagia ostertagi was similar in reindeer (62%) and bovine calves (57%), but larval inhibition was much higher in reindeer (91%, p < 0.001) than in cattle (31%). Very poor establishment of bovine derived Cooperia oncophora was recorded in reindeer calves (2%) compared with bovine calves (59%). These results show that young reindeer are susceptible hosts to the important gastrointestinal parasites of sheep (T. circumcincta, H. contortus) and cattle (O. ostertagi), as well as being a suitable host for T. axei.

Animals↗

PubMed2001

Wheat starch, gliadin, and the gluten-free diet.

Individuals with celiac disease generally are advised to follow a lifelong gluten-free diet and avoid consumption of the prolamins gliadin (wheat), secalin (rye), and hordein (barley). Although the designation of the diet as glutenfree may imply that the diet contains zero gluten, this is not necessarily true. In some countries (eg, United States, Canada), the gluten-free diet is completely devoid of gluten and is based on foods such as rice and corn that are naturally gluten free. In others (eg, Scandinavia, United Kingdom), the gluten-free diet may include foods such as wheat starch that have been rendered gluten free but nonetheless contain small amounts of toxic prolamins. The discrepancy in the use of foods rendered gluten free exists because the amount of toxic prolamins that individuals with celiac disease may consume without damaging the mucosa of the small intestine is unknown. Minimal research has been conducted on the toxicity of foods rendered gluten free, and there are no definitive data about whether the small amount of prolamin found in these products is safe to consume. Nonetheless, the Codex Alimentarius Standard for gluten-free foods allows a certain amount of prolamin in foods designated gluten free, and these products have been used in many countries for several decades. Well-designed, scientifically sound studies are needed to help determine the amount of toxic prolamins, if any, that may be safely consumed by individuals with celiac disease. Until this research is conducted, dietitians in the United States should continue to advise their patients against the use of wheat starch and other foods rendered gluten free.

Celiac Disease↗

PubMed1984

Biochemistry and clinical chemistry of vitamin B12 transport and the related diseases.

This review focusses on research performed by the author and coworkers. The absorption, turnover and excretion of cobalamin and the pathogenesis of cobalamin deficiency states are described and the laboratory tests used to diagnose these states are discussed. Topics dealt with in detail include: overall turnover, daily need, enterohepatic circulation and excretion of cobalamin and other corrins . The soluble proteins mediating cobalamin transport and their cellular receptors are described and their nomenclature, isolation, structure and mode of action, the role of calcium in the membrane transport, the evolution of these systems and the analogies with transport systems for other substrates are discussed together with deficiency states, especially fish tapeworm anemia and familial selective vitamin B12 malabsorption with proteinuria. Folate deficiency is a relatively rare cause of megaloblastic anemia in Scandinavia but common in North America and explanations for this difference are suggested. The methods of assaying cobalamin in serum and plasma and the performance of radiovitamin B12 absorption tests are critically evaluated. The measurement of intrinsic factor in gastric juice, serum, amniotic fluid and urine is described.

Anemia, Megaloblastic↗

PubMed1995

Flat neoplastic lesions of the colon and rectum detected by high-resolution video endoscopy and chromoscopy.

Because small flat colorectal neoplastic lesions (i.e., flat adenomas and flat adenocarcinomas) may be as translucent as the surrounding mucosa, they can remain undetected at conventional endoscopy. By combining high-resolution video endoscopy and chromoscopy, we detected 109 colorectal flat neoplastic lesions in 55 of 232 patients studied. Forty-three (78%) of the 55 patients with flat neoplastic lesions were over 60 years of age. No flat neoplastic lesions were seen in patients under 40 years of age. Flat neoplastic lesions were more frequent in men (35%) than in women (15%). Seventy-seven (71%) of the 109 flat neoplastic lesions measured 0.5 cm or less, 23 (21%) between 0.6 and 1.0 cm, and 9 (8%) more than 1.0 cm. Low-grade dysplasia and high-grade dysplasia were found in 94 (86%) and 13 (12%) of the flat neoplastic lesions, respectively. Adenocarcinoma was diagnosed in 3 (3%) flat lesions: 1 (1%) carcinoma originating in a flat adenoma and 2 (2%) adenocarcinomas without recognizable adenomatous elements. No adenocarcinomas were seen in lesions measuring 1.0 cm or less. Fourteen flat neoplastic lesions had a central depression at endoscopy. Flat neoplastic lesions with central depression more frequently showed high-grade dysplasia (43%) than did flat neoplastic lesions without central depression (7%). Central depression in flat neoplastic lesions should be considered a possible endoscopic marker for severe dysplasia. Our results suggest that flat neoplastic lesions occur more frequently than previously reported in Scandinavia. Flat adenomas may play an important role in the histogenesis of colorectal cancer.

Adenocarcinoma↗

PubMed1999

Hospital separation rates from osteoporotic and non-osteoporotic fractures in metropolitan and rural Australia.

Rural populations of the United Kingdom and Scandinavia have lower hospital discharge and incidence rates for hip fractures than urban ones. We compared hospital separations from fractures in rural health regions of Victoria, Australia, with those in metropolitan regions. Fractures were grouped into those commonly (1A), often (1B) or not often (2) associated with osteoporosis. For group 1A fractures, we found rural separation rates were significantly higher among both men and women who were aged either 20-24 or 45-64. The rural separation rates for group 1B fractures were also significantly higher in these age groups but only among men. For group 2 fractures, rural separation rates were significantly higher among young adults. Fractures of the neck, trunk, radius and ulna, but not neck of the femur, contributed to the rural excess of group 1A fractures. If rural adults are not hospitalised more often, risk factors for group 1 and group 2 fractures, which in the middle aged includes osteoporosis, may be more prevalent in rural Victoria. Our findings suggest that international studies of rural-urban differences in fracture rates are needed which include a range of anatomical sites.

Adult↗

PubMed1998

The application of chaetotaxy in the discrimination of Gyrodactylus salaris Malmberg, 1957 (Gyrodactylidae: Monogenea) from species of the genus parasitising British salmonids.

The chaetotaxy of argentophilic structures on three species of the monogenean genus Gyrodactylus was investigated in an attempt to distinguish species of this genus. Maps were prepared for Gyrodactylus salaris from Scandinavia and compared with two native species of Gyrodactylus parasitising salmonids in Britain, namely Gyrodactylus derjavini and Gyrodactylus truttae. The maps were subsequently refined and analysed for zones of homology and differentiation. The results demonstrate that G. salaris can be readily distinguished by this technique, which is, therefore, of great potential value in the identification of this notifiable pathogen. The key aggregations of sensilla discriminating G. salaris are, ventrally, the antero-ventral set, the medio-lateral set and the postero-lateral set, and, dorsally, the postero-dorsal set.

Animals↗

PubMed1999

Motor system abnormalities in heterozygous relatives of a D90A homozygous CuZn-SOD ALS patient of finnish extraction.

Presently, 64 mutations in the gene encoding the enzyme CuZn-superoxide dismutase have been found in a small fraction of amyotrophic lateral sclerosis patients worldwide. All but one of these mutations show autosomal dominant inheritance. In Scandinavia, the D90A mutation is inherited as an autosomal recessive trait and patients have an easily recognizable characteristic phenotype with little variation among patients, even amongst different families. Importantly, all D90A heterozygous relatives of Scandinavian D90A homozygous patients have been reported as clinically unaffected. We have investigated a Canadian family of Finnish extraction in which the D90A homozygous proband developed ALS with the characteristic phenotype. Remarkably, two D90A heterozygous relatives show slight symptoms and signs of motor system involvement, suggesting that the final phenotype of an individual with a CuZn-superoxide dismutase mutation is shaped by the combination of the particular CuZn-SOD mutation, other polymorphic modifying genes elsewhere in the genome, stochastics and possible environmental factors.

Aged↗

PubMed1993

Infantile hypertrophic pyloric stenosis and hydronephrosis: is there an association?

Infantile hypertrophic pyloric stenosis is a common condition requiring surgical intervention during the first few weeks of life. The incidence of infantile hypertrophic pyloric stenosis ranges from 0.13 to 0.4% of live births in the United States, Britain and Scandinavia. Associated anomalies have been described in 6 to 33% of the cases in the central nervous system, gastrointestinal tract and heart. An association of infantile hypertrophic pyloric stenosis with urinary tract anomalies has not been previously documented. A review of 422 patients with infantile hypertrophic pyloric stenosis revealed urinary tract anomalies in 6 (10 renal units), including 4 renal units with vesicoureteral reflux and 9 with hydronephrosis. This incidence of 1.4% is greater than the 0.2% incidence expected in the general population. This 7-fold increase in urinary tract anomalies in patients with infantile hypertrophic pyloric stenosis suggests an association between the two and warrants further investigation. Serious consideration should be given to obtaining renal ultrasound examinations in patients with infantile hypertrophic pyloric stenosis.

Abnormalities, Multiple↗

PubMed1988

Papillary cystadenoma of the epididymis.

There have been 33 previously reported cases of papillary cystadenoma of the epididymis. To our knowledge we report the first case of this benign neoplasm in Scandinavia. The cystic tumor occurred unilaterally in a 44-year-old man who had no signs of von Hippel-Lindau's syndrome or infertility. Papillary cystadenoma of the epididymis must be distinguished from neoplasms of the testis, particularly teratoma.

Adult↗

PubMed2000

Intrusion errors in numerical transcoding by Alzheimer patients.

The errors made by brain-damaged patients when they attempt numerical transcoding tasks have recently been considered as a possible aid to early diagnosis of the disease. The transcoding errors of 20 Alzheimer's disease patients are described, and the incidence of each kind of error compared with norms from healthy subjects. Tegnér and Nybäck (Tegnér R, Nybäck H. "To hundred and twenty4our": a study of transcoding in dementia. Acta Neurologica Scandinavia 1990; 81: 177-178) reported that Alzheimer patients often express numerical information in a mixture of verbal and digital codes and Kessler and Kalbe (Kessler J, Kalbe E. Written numerical transcoding in patients with Alzheimer's disease. Cortex 1996; 32: 755-761) suggested that such intrusions of the source code into the target code may not only be largely absent from the responses of the healthy population, but also from the transcoding operations of patients with other kinds of brain damage, such as aphasia. It was found that intrusion errors occurred much more frequently in the transcoding protocols of some of the Alzheimer patients than they do in those of healthy subjects. On the other hand, they were entirely absent from the protocols of other Alzheimer patients. The implications of the findings for the early diagnosis of Alzheimer's disease are discussed, and the phenomenon of intrusion errors is considered in terms of some of the models of arithmetical processing that have been proposed.

Aged↗

PubMed1975

A technique for partial mastectomy.

Operations less than mastectomy for carcinoma of the breast are not new. Adair in this country, Porritt in England, and Muskatallio in Scandinavia reported early results of operations less than mastectomy, and more recently, Wise et al. in England, and Crile et al. in this country have published their results. The term partial mastectomy has often been labeled "lumpectomy", a deplorable term, and much confusion exists concerning the proper technique of partial mastectomy and its application. The purpose of this article is to discuss the selection of patients for partial mastectomy and to review the fundamental techniques of the procedure.

Biopsy↗

PubMed1997

The incidence and time-course of latanoprost-induced iridial pigmentation as a function of eye color.

Latanoprost, a phenyl-substituted analogue of prostaglandin F2 alpha administered as eye drops, induces increased melanogenesis in the iridial melanocytes of monkeys. Similar effects were seen in 12, 23 and 11% of patients in the USA, United Kingdom (UK) and Scandinavia, respectively, during one year of treatment. The highest incidence of induced pigmentation was seen in green-brown, yellow-brown and blue/grey-brown eyes, in that order. The relatively high proportion of patients with green-brown eyes in the UK explains the larger number of affected patients in this country. Typically, a concentric increase of the iris pigmentation appeared after six months (range: 3-17) and was judged to be noticeable by the patient in about 2/3 of the cases. After cessation of latanoprost, no change of the induced pigmentation has been seen in patients followed for two years, and there have been no signs of dispersion of pigment into the anterior chamber. Irides, homogeneously blue, grey, green or brown, were seldom affected. Naevi or freckles on iris, conjunctiva, or eye lids were not affected. It is intriguing that many patients with mixed eye color, particularly the blue-brown eyes, have not developed increased pigmentation even during two years of treatment. This could be due to a relatively slow melanogenesis or to refractory melanocytes in these individuals.

Adrenergic beta-Antagonists↗

PubMed1999

Organochlorines in deep-sea fish from the Nordfjord.

Hepatic levels of OCs (Organochlorines) were analysed in deep-sea fish from the Nordfjord in Norway. Levels of PCBs in the present study exceed background levels in fish from Norwegian water by a factor of 1.5 to 50, and DDTs by one to two orders of magnitude. DDTs in fish from the Nordfjord have previously been attributed to DDT use in fruit orchards. The present levels of DDTs show that the decline usually found in biota in Scandinavia since the 1970s is not found in the deep-sea fish in Nordfjord. There is no known local PCB source that can explain the elevated levels in the present study. This indicates that the fjord efficiently accumulates atmospheric contaminants. Chlordanes and HCB were less important, and HCHs were not detected.

Animals↗

PubMed2001

Clinical predictors of spontaneous acute urinary retention in men with LUTS and clinical BPH: a comprehensive analysis of the pooled placebo groups of several large clinical trials.

OBJECTIVES: To comprehensively evaluate clinical predictors of spontaneous acute urinary retention (AUR) across pooled data of placebo-treated patients from clinical trials conducted in men with lower urinary tract symptoms and clinically diagnosed benign prostatic hyperplasia. METHODS: Data from the placebo-treatment groups of several prospective, randomized clinical trials conducted in the United States (n = 3040), Scandinavia, Canada, and worldwide (n = 2295) were combined in the analyses. More than 110 variables were considered individually and in combination as predictors of AUR using logistic regression analysis and classification and regression tree methods with a split-sample approach to cross-validation. RESULTS: The different methods of analysis identified consistent potential predictors of episodes of AUR. When prostate volume was included in the analyses, it was selected as the initial variable discriminating men with and without subsequent AUR. Omitting prostate volume because of its availability in only a subset of men, a logistic model including serum prostate-specific antigen (PSA), urinating more than every 2 hours, symptom problem index, maximum urinary flow rate, and hesitancy of urination had good predictive properties (area under the receiver-operating characteristic curve [AUC] = 0.742 +/- 0.047), as did a model with PSA (AUC = 0.716 +/- 0.045). A classification and regression decision tree with the same variables predicted AUR (AUC = 0.74, sensitivity = 72%, specificity = 67%) as well as did a tree with PSA alone (AUC = 0.70, sensitivity = 75%, specificity = 64%). CONCLUSIONS: Prostate volume and serum PSA are strong predictors of AUR in placebo-treated men with lower urinary tract symptoms and clinically diagnosed benign prostatic hyperplasia who were screened for prostate cancer. From more than 110 variables, logistic models and decision trees with PSA alone were comparable to expanded models that included PSA, urinary frequency and hesitancy, flow rate parameters, and symptom problem index, and to a scoring algorithm.

Algorithms↗