Biomedical subjects
Publications and source records attributed to E Johansson.
The reproducibility of multivariate measurements is discussed. Reproducibility of a second kind is defined, in which part of the variability between samples is described by a principal components model. The use of this generalized reproducibility is shown to give an improved precision in the pyrolysis-gas chromatography of a Penicillium species.
Repetitive samples of three strains of the mould Penicillium were subjected to pyrolysis-gas chromatography (Py-GC). From the chromatograms, 26 peak heights were used in a subsequent SIMCA pattern recognition analysis. This data analysis gives a marked improvement in the classification of the samples (100% correct, 85% unique) in comparison with the traditional analysis based on the average chromatogram of each class (92% correct, 45% unique). The data analytical method is described in detail using the Py-GC data as an illustration.
A sample of 36 juvenile diabetics, age 19--28 years, and with a duration of diabetes of 14--17 years were interviewed with regard to their social adaptation. Five patients could not be traced and six patients did not want to participate. Educational and professional careers were normal. However, none had received individual diabetes-oriented vocational guidance. A majority of patients was unsatisfied with the information given at the diabetic clinics, and a negative attitude towards society and its institutions was common. Patients often felt that as children they had been neglected by the diabetic team, while their parents received all information. It is concluded that diabetic children and adolescents require continuous socio-psychological support, that psychologists and/or social workers should be permanent members of the diabetic teams, and that paediatricians should follow diabetic patients until they are fully grown up.
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Warts were found in 25 out of 56 patients with definite or probable systemic lupus erythematosus (SLE) but in only 19 out of 160 control patients. Warts were particularly prevalent in elderly patients with SLE. The corticosteroid and antimalarial drugs used to treat SLE did not influence the frequency of warts. Wart-virus antibodies were found significantly less often in patients with SLE than in controls: antibodies were detected in 23 out of 51 patients and in 40 out of 54 controls. Ihe findings suggest that some deficiency in the immune mechanisms of patients with SLE predisposes them to develop warts. There was an inverse correlation among the patients with SLE between the occurrence of warts and rheumatoid factor activity. This suggests that rheumatoid factor may interfere with resistance to warts.
The investigation comprises 19 patients with acute deep vein thrombosis of the leg treated with streptokinase. The acute clinical symptoms rapidly subsided in 15 patients. Phlebography, performed immediately after treatment, revealed complete thrombus regression in 7 cases, restoration of venous flow but remnants of thrombi in 4 and no effect in 7. One woman was not evaluated radiologically due to pregnancy. The phlebographic restoration seemed to be correlated to the duration of the thrombotic symptoms. Follow-up examinations 6-50 months after the thrombotic incident demonstrated normal phlebograms in 8 patients, all of whom were also free from post-thrombotic symptoms. Venous occlusion plethysmography confirmed that these patients had a normal venous outflow capacity and valvular function in the relevant limbs. By contrast, the remaining 11 patients, with more or less extensive remnants of thrombi at the follow-up phlebography, were found to have plethysmographic signs of venous obstruction and sometimes also valvular insufficiency. The results indicate that thrombolytic treatment is able to give a complete and lasting anatomical and functional restitution of the deep veins after an acute thrombosis in the leg, provided that treatment is induced early enough.
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Norethindrone (NET) contained in silicone rubber, for slow release, was implanted subcutaneously. The rate of release of NET was 10-12 mug/day/10 mm length of the silicone rubber. The total length of the implants used varied from 100 mm to 200 mm. During the whole observation time 562 women months, 14 a-cidental pregnancies occurred. The pregnancy rate decreased with increasing length of implants. The implants produced a transient ovulation suppression, which subsided in four to five cycles. The plasma levels of NET stabilized at a level which was less than that reached by daily oral administration of 350 mug of NET. The high pregnancy rate and the great number of implants required render the method impractical for contraception. However, the active life-span of implants is three years and because there were few minor side-effects, the method was well accepted.
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Altogether 173 patients with warts were under observation for at least 3 and in most cases 6 months. In 80% of the patients wart-virus antibodies were present and could be measured by immunodiffusion (I.D.) and in 20% also by complement-fixation (C.F.) techniques. The mean duration of the warts in patients with C.F. antibodies was 0-6 years and in the others 1-9 years. The occurence of C.F. antibodies (IgG) was associated with rapid healing; 75% of these patients were cured during the first 2 months of the observation period. In contrast, of the patients with antibodies measurable only by the I.D. technique (IgM and/or low titres of IgG), only 16% were cured during the first 2 months and they had a fairly constant cure-rate (approximately 9% per month) during the 6 months' observation period. The results indicate that the cure of warts is partly connected with immunological phenomena, especially with the presence of C.F. antibodies. In other cases wart regression may be mainly a non-immune process, perhaps due to a limited lifespan of wart cells.
During streptokinase treatment of an iliofemoral thrombosis, a formerly healthy man developed clinical signs of major pulmonary embolism. In spite of all attempts at resuscitation, the patient died after 1.5 hours. The autopsy showed no signs of remaining thrombus or emboli. The probable explanation is that the thrombus had partially been lysed and that the remaining parts formed an embolus large enough to cause considerable haemodynamic changes which could not be influenced. Lysis continued pre- and postmortally and was complete at the time of autopsy.
The incidence of postoperative deep venous thrombosis in the lower limbs and of pulmonary embolism has been studied in 49 patients operated upon for gallbladder and gastric diseases. 125I fibrinogen test was performed preoperatively and usually five times postoperatively. Pulmonary scintigraphy was also performed preoperatively and usually twice after the operation. An attempt was made to evaluate the prophylactic effect of Dextran 40. Only one patient developed a deep vein thrombosis without clinical signs. Postoperative pulmonary embolism was found in 13 patients, all but one clinically silent. The second postoperative pulmonary scintigraphy showed that the emboli had disappeared or diminished in 6 patients. Because of the low number of patients with deep venous thrombosis the prophylactic effect of Dextran 40 could not be assessed. The present investigation showed that the incidence of deep venous thrombosis in the legs was low after operations in the upper part of the abdomen while the incidence of pulmonary embolism was high. No connection between leg vein thrombosis and pulmonary embolism could be demonstrated.
The HL-A phenotype of 17 patients with a typical clinical picture of circinate erosive balanitis was determined. Eight of the patients had other signs of Reiter's disease and 9 had balanitis alone. HL-A 27 was found to be present in 15 of the 17 cases. One patient of each group lacked this antigen. The frequency of the other histocompatibility antigens did not significantly differ from that of a Finnish control population.