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Biomedical subjects

B Lind

Publications and source records attributed to B Lind.

At least 37 records · Page 2Linked to original sources

Outcome scores in degenerative cervical disc surgery.

Forty-six consecutive patients with neck pain and arm radiculopathy were treated with anterior cervical discectomy and fusion. All patients had neurological symptoms corresponding to a herniated disc and/or spondylosis at one or two cervical levels, verified by magnetic resonance imaging. The patients were stabilized with an anterior graft and randomized to either fixation with a CSLP plate or no internal fixation. Preoperatively and 2 years postoperatively the patients filled in a questionnaire that included a modified Million Index, a modified Oswestry Index and the Zung Depression Scale. They were also asked to register their pain in the arm and in the neck on a vertical visual analogue scale (VAS). At the 2-year follow-up, an unbiased observer graded the patients' clinical outcome using Odom's criteria. A test-retest procedure was carried out to examine the questionnaire reproducibility. In the group that was operated at one level, there was no significant improvement in any of the scores. Nevertheless, 81% of the patients were satisfied with the outcome of the surgery. All scores improved in the group operated at two levels. The pain in the neck and arm, as measured on a VAS, decreased in both groups. The improvement in arm pain was significantly more pronounced in patients operated with a plate at two levels compared to those who were operated without a plate. At the 2-year follow-up, patients with an excellent or good result according to Odom's criteria had a lower Million Index (P < 0.0005), Oswestry Index (P < 0.0005), and Zung (P = 0.024) score, than the group classified as fair or poor. There was a significant correlation (P < 0.0001 for all scores) between the test and retest results. We conclude that the modified Million Index and Oswestry Index are clinically useful tools in the evaluation of outcome after degenerative cervical disc surgery. The clinical benefits of plate fixation were minimal. The outcome after surgery, measured with the Oswestry Index, Million Index and VAS for arm and neck pain, seems to correlate well with the classification of outcome by Odom.

Adult↗

Long-term cardiac mortality following radiation therapy for Hodgkin's disease: analysis with the relative seriality model.

PURPOSE: (a) To assess the increased risk of death due to ischemic heart disease (IHD) in a group of patients treated for Hodgkin's disease (HD) with radiation therapy (RT) as the primary treatment. (b) To quantify the dose response of IHD using a biophysical model. MATERIALS AND METHODS: Patient material consisted of 157 patients diagnosed for HD between 1972 and 1985 who received RT as the primary treatment at Radiumhemmet, Karolinska Hospital. The general population formed the control group. The RT treatments were reconstructed based on the individual treatment data and simulator films. Individual clinical and dosimetrical data were analyzed with the relative seriality model. The material was also analyzed grouping the material according to dose-volume constraints. RESULTS: Of the 157 patients, 13 (8.3%) died due to IHD. The standardized mortality ratio (SMR) was 5.0 (95% CI, 2.7-8.6). Analysis of dose-volume histograms (DVH) showed an increasing risk with increasing dose to a larger volume fraction. The observed individual clinical complication data could not be modeled unambiguously. The group analysis resulted in the dose-response parameters: D(50)=71 Gy, gamma=0.96 and s=1.0. CONCLUSIONS: A significantly increased risk of death due to IHD following RT for HD was found. The risk was found to increase with higher dose and larger volume fraction irradiated.

Adolescent↗

Linkage of a composite inhibitory phenotype to a chromosome 22q locus in eight Utah families.

Eight Utah multigenerational families, each with three to six cases of schizophrenia, were phenotyped with two specific measures of inhibitory neurophysiological functioning, P50 auditory sensory gating (P50), and antisaccade ocular motor performance (AS). A genomewide linkage analysis was performed to screen for loci underlying a qualitative phenotype combining the P50 and AS measures. For this composite inhibitory phenotype, the strongest evidence for linkage was to the D22s315 marker on chromosome 22q (lod score = 3.55, theta = 0) under an autosomal dominant model. Simulation analyses indicate that this 3.55 lod score is unlikely to represent a false positive result. Lod scores were 2.0 or greater for markers flanking D22s315. A nonparametric linkage (NPL) analysis of the chromosome 22 data showed evidence for allele sharing over the broad region surrounding D22s315 with a maximum NPL score of 3.83 (p = .002) for all pedigrees combined.

Acoustic Stimulation↗

Property damage and public disorder: their relationship with sales of alcohol in New South Wales, Australia.

It has been suspected for some time that alcohol is involved in the origin of offensive behaviour and property damage incidents. Using regression analyses and a cross-sectional design, this study investigates these relationships for both Sydney and country New South Wales (NSW), whilst controlling for key social and demographic variables. The study found that both offence types occurred more frequently in areas with greater sales of alcohol. The effect of alcohol sales was considerably larger in Sydney than it was in country NSW. There was an interaction between aboriginal population size and alcohol sales for country NSW offensive behaviour data. Overall, these findings are consistent with alcohol consumption playing a causal role in these offences, however, the possibility remains that alcohol sales may be acting as an indicator of criminal opportunity.

Age Factors↗

Fluctuations in heroin purity and the incidence of fatal heroin overdose.

In order to determine the role played by heroin purity in fatal heroin overdoses, time series analyses were conducted on the purity of street heroin seizures in south western Sydney and overdose fatalities in that region. A total of 322 heroin samples were analysed in fortnightly periods between February 1993 to January 1995. A total of 61 overdose deaths occurred in the region in the study period. Cross correlation plots revealed a significant correlation of 0.57 at time lag zero between mean purity of heroin samples per fortnight and number of overdose fatalities. Similarly, there was a significant correlation of 0.50 at time lag zero between the highest heroin purity per fortnight and number of overdose fatalities. The correlation between range of heroin purity and number of deaths per fortnight was 0.40. A simultaneous multiple regression on scores adjusted for first order correlation indicated both the mean level of heroin purity and the range of heroin purity were independent predictors of the number of deaths per fortnight. The results indicate that the occurrence of overdose fatalities was moderately associated with both the average heroin purity and the range of heroin purity over the study period.

Adolescent↗

The relationship between alcohol sales and assault in New South Wales, Australia.

AIMS: This paper explores the relationship between alcohol sales and assault in New South Wales (NSW), Australia. DESIGN: The design was a cross-sectional analysis of the relationship between alcohol sales and assault, taking into account spatial autocorrelation. SETTING: The analyses were carried out separately on data from metropolitan Sydney and country NSW. PARTICIPANTS: The unit of analysis was local government areas (178 in NSW). MEASUREMENTS: The dependent variable was assault rates. The independent variables were overall alcohol sales and sales disaggregated by alcohol and outlet type and relevant demographic and socio-economic factors. FINDINGS: Multiple regression analyses revealed a significant relationship between overall alcohol sales in an area and its incidence of assault for both Sydney and country NSW. There were few effects of outlet or alcohol type for Sydney, but the effect of alcohol sales from hotels and off-licences accounted for most of the alcohol-assault relationship for country NSW. CONCLUSIONS: Although the current research cannot exclude an opportunity account of the role of alcohol in assault, the results are entirely consistent with alcohol consumption as a causal agent.

Alcohol Drinking↗

A novel missense mutation in the human plasmin inhibitor (alpha2-antiplasmin) gene associated with a bleeding tendency.

Heterozygosity for a G --> A mutation converting Val384(GTG) to Met(ATG) associated with plasmin inhibitor (alpha2-antiplasmin) deficiency was identified in three family members with bleeding tendency. The proband had traumatic breast haematoma and per-/postoperative bleeds. An affected daughter required a blood transfusion after a normal delivery and a son had prolonged bleeding after tooth extraction. The plasma plasmin inhibitor activities of the affected family members were reduced to 49-66% of normal. The antigenic concentrations determined by electroimmunoassay were reduced to 57-68% of normal. Crossed immunoelectrophoresis of plasma from the proband showed a normal pattern. The amino acid Val384 is located eight residues C-terminal (P8') of the P1 residue (Arg376) in the reactive site. The P8' residues of bovine and mouse plasmin inhibitor are both Val. Among other serpins the P8' residue is unconserved. The mutation was not present in the non-affected family member or 30 blood donors. In addition to the Val384Met mutation two new polymorphisms Ala-26(GCG)/Val(GTG) and Arg407(AGG)/Lys(AAG) and one previously reported polymorphism Arg6(CGG)/Trp(TGG) were identified in the plasmin inhibitor gene of the family. The allelic frequencies among 30 blood donors with normal values of plasma plasmin inhibitor (functional) were 0.84/0.16 for C/T in codon -26, 0.81/0.19 for C/T in codon 6 and 0.83/0.17 for G/A in codon 407.

Adult↗

The Olerud Cervical Fixation System; a study of safety and efficacy.

To evaluate safety and efficacy of the Olerud Cervical Fixation System a one-year follow up study was done by an independent observer. There were 30 patients (14 women) with a mean age of 68 (37-85) years. Indications were rheumatoid arthritis in 10, spinal stenosis in 6, trauma in 6, metastases in 4, revisions in 3, and painful spondylotic deformity in one patient. Short fusions were performed in 8 patients and long fusions in 22. Four patients were fused to occiput. C1-C2 fusion was performed in 3 patients. Nineteen of the 20 still alive were evaluated at follow up. One patient was deliberately fused in hyperlordosis, in the rest the alignment was acceptable. Primary stabilization was achieved in all but one. 107 pedicle screws were used; one screw in Th2 was placed lateral to the pedicle. 42 subaxial transarticular screws were used. There were no complications related to these screws. One patient experienced a non-instrument related neurological deterioration. Two infections and one hematoma drainage healed on conservative treatment. Loss of fixation and non-union developed in 2 patients. Patients with metastasis or myelopathy due to rheumatoid arthritis carried a high mortality risk. The Olerud Cervical Spine Fixation System is versatile in posterior fixation of the cervical spine and has proven to be both safe and efficient.

Adult↗

[Comparison of conventional PAP smears with thin layer specimen (liquid-based PAP test) and correlation with cytopathological findings with HPV status using the hybrid capture system].

Cervical smears of 554 outpatients of a hospital were examined using a blinded, split sample match pair protocol for which a conventional PAP-smear (CS) was first prepared with Cervex brush and the reminder of the sample was used for the thin-layer-preparation (TLP) according to the manual CytoRich System. The preparations of the two methods were compared with respect to quality and to sensitivity for atypias. In addition the HPV status was determined on the same cell suspension in cases with borderline changes (BLC) and dysplasias including carcinoma using the Hybrid Capture System. The use of TLP reduced the proportion of suboptimal preparations by more than 50% (14.6% vs. 35%) and eliminated the only inadequate preparation registered in CS. The DSP detected more than twice as many dysplasias of all degrees as CS (3.4% vs. 1.4%) and reduced the proportion of BLC to one third (3.2% vs. 9.6%). The percentages of cases positive for high- and intermediate-risk HPV in preparations with BLC, LSIL and HSIL were 17, 62.5% and 100% respectively. The TL-method improves significantly the efficiency of PAP-smears and allows the typing of HPV which is of clinical importance for the management of low grade squamous intraepitelial lesions and borderline changes. The findings speak against the further use of CS for cervical screening.

Adolescent↗

The absorption, blood levels, and excretion of mercury after a single dose of mercury vapor in humans.

Nine healthy volunteers without amalgam fillings were exposed to 400 micrograms/m3 mercury vapor (Hg0) for 15 min, corresponding to 5.5 nmol Hg0/kg body wt (median range: 4.4-7.2). Frequent sampling of blood, urine, and exhaled air was performed for 30 days after exposure. The median retention of Hg0 was 69% of the inhaled dose. During the first 3 days after exposure 7.5-12% of the absorbed dose was lost by exhalation, with the median half time of Hg0 in expired breath being 2.0 days. In blood and plasma, a rapid absorption phase of Hg was seen, followed by a biexponential decline of the curves in both media. A substantial interindividual variation was observed in the area under the concentration-time curves of Hg in blood and plasma. In plasma the median half time of the second phase was 10 days. About 1.0% of the absorbed Hg was excreted via urine during the first 3 days after exposure, whereas the estimated amount excreted during 30 days ranged from 8 to 40%. In order to evaluate the chronic exposure to mercury from dental amalgam in the general population, the daily Hg dose from the fillings were estimated based on the plasma Hg levels found in subjects with amalgam fillings and on the plasma Hg clearance obtained in the present study. The daily Hg dose was estimated to 5-9 micrograms/day in subjects with an ordinary number of amalgam fillings.

Absorption↗

Plate fixation adds stability to two-level anterior fusion in the cervical spine: a randomized study using radiostereometry.

This study evaluated whether addition of a cervical spine locking plate (CSLP) in two-level disc fusions improved the postoperative stability and reduced the time to healing. Radiostereometric analysis was used to obtain precise recordings of the three-dimensional motion between the fused vertebrae. Eighteen consecutive patients were operated on with excision of two adjacent cervical discs and anterior horseshoe grafting with autologous bone (Smith Robinson technique). Nine patients were randomized to stabilization with autologous bone grafting and CSLP plate fixation and nine patients to grafting without fixation. Clinical symptoms in terms of pain in the neck and the arm were analysed preoperatively and after 1 year using a visual analogue scale (VAS). The patients operated without a plate displayed increased rotations around the transverse axis, corresponding to the development of a kyphosis [mean value no plate/plate 14.4 degrees/0.8 degrees (repeated measure ANOVA: P < 0.01)]. The mean compression was 3.2 mm larger in patients operated without a plate (repeated measure ANOVA: P < 0.01). Patients operated without a plate had more arm pain at the 1-year follow up (P < 0.05, Mann-Whitney U test). The VAS score for neck pain did not differ significantly between the two groups. Plate fixation could not be demonstrated to increase the healing rate, promote more rapid fusion or influence the frequency of graft complications.

Adult↗

Analysis of chromosome 6 markers in eight Utah schizophrenia pedigrees.

Eight multiplex Utah schizophrenia pedigrees were screened for linkage by applying a non-parametric linkage program, GENEHUNTER, using 30 chromosome 6 DNA markers. The overall maximum NPL score of the combined pedigrees was 1.50 (P = 0.079) at marker D6s281, located near the q terminus. The highest overall maximum NPL score for an individual pedigree was 2.81 (P = 0.043). In the chromosome 6p region, where numerous positive findings have been reported, we obtained no positive results.

Chromosomes, Human, Pair 6↗

Beam characteristics and clinical possibilities of a new compact treatment unit design combining narrow pencil beam scanning and segmental multileaf collimation.

Not until the last decade has flexible intensity modulated three-dimensional dose delivery techniques with photon beams become a clinical reality, first in the form of heavy metal transmission blocks and other beam compensators, then in dynamic and segmented multileaf collimation, and most recently by scanning high-energy narrow electron and photon beams. The merits of various treatment unit and bremsstrahlung target designs for high-energy photon therapy are investigated theoretically for two clinically relevant target sites, a cervix and a larynx cancer both in late stages. With an optimized bremsstrahlung target it is possible to generate photon beams with a half-width of about 3 cm at a source to axis distance (SAD) of 100 cm and an initial electron energy of 50 MeV. By making a more compact treatment head and shortening the SAD, it is possible to reduce the half-width even further to about 2 cm at a SAD of 70 cm and still have sufficient clearance between the collimator head and the patient. One advantage of a reduced SAD is that the divergence of the beam for a given field size on the patient is increased, and thus the exit dose is lowered by as much as 1%/cm of the patient cross section. A second advantage of a reduced SAD is that the electron beam on the patient surface will be only about 8 mm wide and very suitable for precision spot beam scanning. It may also be possible to reduce the beamwidth further by increasing the electron energy up to about 60 MeV to get a photon beam of around 15 mm half-width and an electron beam as narrow as 5 mm. The compact machine will be more efficient and easy to work with, due to the small gantry and the reduced isocentric height. For a given target volume and optimally selected static multileaf collimator, it is no surprise that the narrowest possible scanned elementary bremsstrahlung beam generates the best possible treatment outcome. In fact, by delivering a few static field segments with individually optimized scan patterns, it is possible to combine the advantage of being able to fine tune the fluence distribution by the scanning system with the steeper dose gradients that can be delivered by a few static multileaf collimator segments. It is demonstrated that in most cases a few collimator segments are sufficient and often a single segment per beam portal may suffice when narrow scanned photon beams are employed, and they can be delivered sequentially with a negligible time delay. A further advantage is the increase of therapeutically useful photons and improved patient protection, since the pencil beam is only scanned where the leaf collimator is open. Consequently, some of the problems associated with dynamic multileaf collimation such as the tongue and groove and edge leakage effects are significantly reduced. Fast scanning beam techniques combined with good treatment verification systems allow interesting future possibilities to counteract patient and internal organ motions in real time.

Algorithms↗

One-level cervical spine fusion. A randomized study, with or without plate fixation, using radiostereometry in 27 patients.

We randomized 27 consecutive patients undergoing 1-level cervical disc surgery to surgery with or without anterior plate fixation. The patients were studied with radiostereometry and clinically with visual analogue scores (VAS) for arm and neck pain. After 2 years, 1 patient had developed pseudoarthrosis, all other fusions were healed, but 1 patient showed substantial motions in the fusion area between the 1- and 2-year follow-ups. The 12 patients operated on without a plate had increased rotations around the transverse axis, corresponding to deformation towards kyphosis. Clinically, there was no difference in outcome between the two groups, as assessed by VAS. The use of an anterior plate in 1-level degenerative disc surgery in the cervical spine seems to prevent rotational deformation, without affecting the clinical outcome or fusion healing.

Adult↗

Radioactive contamination from dumped nuclear waste in the Kara Sea--results from the joint Russian-Norwegian expeditions in 1992-1994.

Russian-Norwegian expeditions to the Kara Sea and to dumping sites in the fjords of Novaya Zemlya have taken place annually since 1992. In the fjords, dumped objects were localised with sonar and ROV equipped with underwater camera. Enhanced levels of 137Cs, 60Co, 90Sr and 239,240Pu in sediments close to dumped containers in the Abrosimov and Stepovogo fjords demonstrated that leaching from dumped material has taken place. The contamination was inhomogeneously distributed and radioactive particles were identified in the upper 10 cm of the sediments. 137Cs was strongly associated with sediments, while 90Sr was more mobile. The contamination was less pronounced in the areas where objects presumed to be reactor compartments were located. The enhanced level of radionuclides observed in sediments close to the submarine in Stepovogo fjord in 1993 could, however, not be confirmed in 1994. Otherwise, traces of 60Co in sediments were observed in the close vicinity of all localised objects. Thus, the general level of radionuclides in waters, sediments and biota in the fjords is, somewhat higher or similar to that of the open Kara Sea, i.e. significantly lower than in other adjacent marine systems (e.g. Irish Sea, Baltic Sea, North Sea). The main sources contributing to radioactive contamination were global fallout from atmospheric nuclear weapon tests, river transport from Ob and Yenisey, marine transport of discharges from Sellafield, UK and fallout from Chernobyl. Thus, the radiological impact to man and the arctic environment of the observed leakages from dumped radioactive waste today, is considered to be low. Assuming all radionuclides are released from the waste, preliminary assessments indicate a collective dose to the world population of less than 50 man Sv.

Aluminum Silicates↗

Radioactive contamination in the environment of the nuclear enterprise 'Mayak' PA. Results from the joint Russian-Norwegian field work in 1994.

A brief overview of the radioactive waste inventory of the 'Mayak' PA reprocessing plant, Chelyabinsk Region, Russia is given together with a description of the environmental contamination caused by its activities and the origins of contamination. The joint Russian-Norwegian field work in 1994 is described, together with the major analytical results. The field work was of a limited extent, and was not designed to include a complete mapping of the environmental contamination around the plant. The results are, however, in good agreement with the very extensive previous Russian investigations. The highest concentrations of radioactivity were found in Reservoirs 10 and 11 and at the floodplain of the upper Techa River (Asanov Swamp). Also high concentrations are found in biota, especially fish from Reservoir 10.

Arctic Regions↗

Naturally occurring Arg(-1) to His mutation in human protein C leads to aberrant propeptide processing and secretion of dysfunctional protein C.

The dysfunctional protein C from a thrombophilic patient heterozygote for a G1388 to A converting the codon for Arg(-1) to His was purified from plasma and characterized. N-terminal amino acid sequence analysis of the light chain of the protein C demonstrated that the dysfunctional protein C is elongated with one amino acid, namely the mutated His. This finding is compatible with disruption by the mutated His of the original basic propeptidase recognition sequence (Arg(-5)-Ile-Arg-Lys-Arg(-1)), resulting in a shift of the cleavage site to a new position, Lys(-2)-His(-1), which follows an alternative basic amino acid propeptidase recognition sequence (Arg(-5)-Ile-Arg-Lys(-2)). Because the mutation affects the propeptide that directs the gamma-carboxylation converting Glu to Gla residues in the Gla domain, it was investigated whether the mutation impaired this reaction. Gla fragment obtained by cleavage of the dysfunctional protein C light chain with endoproteinase Asp-N was isolated by reverse-phase high-performance liquid chromatography, methylated, and subjected to N-terminal sequence analysis. The methylation step enabled the positive identification of Gla residues as well as the determination of the relative amount of Gla and Glu residues at each of the nine gamma-carboxylation sites of the Gla domain. The analysis showed that all nine potential gamma-carboxylation sites of the dysfunctional protein C were normally carboxylated. This result is compatible with the notion that position -1 is not a part of the recognition element for the gamma-carboxylase. In conclusion, evidence is provided showing that the mutation leads to aberrant propeptide processing and secretion of dysfunctional normally carboxylated protein C extended with the mutated His.

Amino Acid Sequence↗