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Biomedical subjects

H Bengtsson

Publications and source records attributed to H Bengtsson.

At least 19 recordsLinked to original sources
PubMed2004

Assessment and evaluation of individual prerequisites for dental education.

Since 2001 the School of Dentistry of Malmo University in Sweden has used an alternative admissions procedure based on results of an investigation supported by the Swedish Council for the Renewal of Undergraduate Education. The investigation concerned possibilities of predicting dental school performance on the basis of an interview, as well as tests of general intelligence, spatial ability, manual dexterity, empathy and social competence. Two groups of incoming students were followed from start to completion of their training. Significant relationships were found between (i) number of course examinations failed and poor results on interviews, as well as low scores on intelligence, spatial ability, and a test of spatial-manual ability, (ii) good results in a pre-clinical course in cavity preparation and high scores on spatial ability, (iii) assessments of high social competence during training and good results on interviews, as well as high scores on empathy and non-verbal intelligence. Dropout from the study programme could not be predicted, possibly due to the varying reasons for it.

Achievement↗
PubMed1999

Evolution of sleep apnea syndrome in sleepy snorers: a population-based prospective study.

This study followed a small number of men previously studied polysomnographically 10 yr earlier to investigate the relationship between the development of sleep-disordered breathing and age, weight gain, and smoking. In 1984, 3,201 men answered a questionnaire including questions about snoring and excessive daytime sleepiness (EDS). Of those reporting symptoms related to obstructive sleep apnea syndrome (OSAS), a random sample of 61 men was investigated using whole-night polysomnography in 1985. Ten years later, 38 men participated in the present follow-up, which included a structured interview and polysomnography. During the 10-yr period, nine men had been treated for OSAS. Of the 29 untreated subjects, the number of men with OSAS, defined as an apnea-hypopnea index (AHI) of >/= 5/h, increased from four in 1985 to 13 in 1995 (p < 0.01). In this small sample, no significant associations were found between DeltaAHI (i.e., AHI 1995 - AHI 1985) and age, weight gain, or smoking. We conclude that, among this small group of individuals who were selected for original polysomnographic study and follow-up because they were thought to have symptoms of sleep apnea, sleep-disordered breathing became significantly worse over time.

Adult↗
PubMed1998

Potentiating interactions between morphogenetic protein and neurotrophic factors in developing neurons.

mRNA for bone morphogenetic protein receptor type II (BMPR-II) was mapped to different neurons in peripheral ganglia and spinal cord of the chicken embryo. The expression of this serine/threonine kinase receptor partially overlaps with that of tyrosine kinase receptors Trk and Ret. Biological activities of osteogenic protein-1 (OP-1), a documented ligand for BMPR-II, were tested in explanted embryonic chicken ganglia and dissociated ganglionic neurons. OP-1 had only a limited stimulatory effect on neuronal survival. However, OP-1 combined with either neurotrophin-3 (NT-3, a relative of nerve growth factor) or glial cell line-derived neurotrophic factor (GDNF) potentiated neuronal survival three- to fourfold. We also show that OP-1 strongly potentiates nerve fiber outgrowth from ganglia stimulated with NT-3 or GDNF. Signaling by BMPR-II in neurons may potentiate the tyrosine kinase pathway activated by NT-3 and GDNF. The data suggest that morphogenetic proteins may modulate neurotrophic activities during neuronal development and plasticity.

Amino Acid Sequence↗
PubMed1998

BMPR-II expression and OP-1 effects in developing chicken retinal explants.

Low-stringency PCR was used to isolate the chicken homologue of the human bone morphogenetic protein receptor type II (BMPR-II). In situ hybridization localized mRNA expression for this serine/threonine kinase receptor. It was weakly expressed in the vitreal side of the neural retina at E6. In the E7 chicken, fairly strong labelling was found in cells of the internal part of the neural retina. At E9, strong labelling was found in the region of the retinal ganglion cells. Explants of E6 retina exposed to osteogenic protein-1 (OP-1/BMP-7), exhibited dense retinal fibre outgrowth. This suggests that BMPR-II may form a signalling receptor complex important for retinal development. OP-1 and related ligands may serve functions supplementary to those of neurotrophins.

Amino Acid Sequence↗
PubMed1998

Bone morphogenetic proteins and their receptors: potential functions in the brain.

Transforming growth factors-beta (TGF-betas), activins, and bone morphogenetic proteins (BMPs) comprise an evolutionarily well-conserved group of proteins controlling a number of cell differentiation, cell growth, and morphogentic processes during development. The superfamily of TGFbeta-related genes include over 25 members in mammals several of which are expressed in the growing nervous system and serve important functions in regionalizing the early CNS. Cultured nerve cells show different responses to these factors. Recent developments have revealed that TGFbetas, activins, and BMPs selectively signal to the responding cells via different hetero-oligomeric complexes of type I and type II serine/threonine kinase receptors. The adult brain exhibits specific expression patterns of some of these receptors suggesting neuronal functions not only during development but also in the mature brain. In particular, the brain is expressing high levels of bone morphogenetic protein receptor type II (BMPR-II), activin receptor type I (ActR-I), and activin receptor type IIA (ActR-II). This indicates that osteogenic protein-1 (OP-1/BMP-7), BMP-2, and BMP-4 as well as activins may serve functions for brain neurons. Expression of the receptors partially overlaps in populations of neurons and has been shown to be regulated by brain lesions. This suggests that brain neurons may use receptors BMPR-II and ActR-I to sense the presence of BMPs. This may form a system parallel to the neurotrophin Trk tyrosine kinase receptors regulating neuroplasticity and brain repair. The presence of BMPs in brain is not well studied, but preliminary in situ data indicate that the BMP relatives growth/differentiation factor (GDF)-1 and GDF-10 are distinctly but differentially expressed at high levels in neurons expressing BMPR-II and ActR-I. The receptors mediating responses to these two GDFs remain, however, to be defined. Finally, recent data show that the signal from the activated type I serine/threonine kinase receptor is directly transduced to the nucleus by Smad proteins that become incorporated into transcriptional complexes. Preliminary in situ hybridization observations demonstrate the existence of different Smad mRNAs. It is concluded that BMPs and their signaling systems may comprise a novel pathway for control of neural activity and offer means for pharmacological interventions rescuing brain neurons.

Animals↗
PubMed1998

A descriptive study of how dentists view their profession and the doctor-patient relationship.

In this article we report on how 64 dentists working in a big city in southern Sweden view their profession. The dentists ranged in age from 30 to 70 years (as it was indicated in intervals of 10 years). Their professional experience ranged from 2 to 44 years (mean, 23 years). We collected their views on the ideal skills of a good dentist by means of a questionnaire. From this material we identified three categories: 1) interpersonal skills; 2) clinical skills; and 3) others, such as self-confidence, stress tolerance, and managerial and administrative skills. Next, they rated the relative importance of a number of listed attributes in dentistry in this order: contact with patients, communication skills, empathy, manual skills, and theory. Finally, they described a number of aspects of their profession. We conclude that the importance of interpersonal skills, as well as stress tolerance and administrative skills, is emphasized by experienced practitioners but that these skills are not focused on in the dental curriculum.

Adult↗
PubMed1997

Long-term follow-up of patients with obstructive sleep apnea treated with uvulopalatopharyngoplasty.

OBJECTIVE: To study the long-term outcome after treatment with uvulopalatopharyngoplasty (UPPP). DESIGN: Long-term follow-up (4-8 years) with polysomnography. SETTING: Referral center for patients with sleep-disordered breathing. PATIENTS: Thirty-four consecutive patients of whom 25 (22 men and 3 women; mean age, 49 years) participated in the follow-up. All patients had obstructive sleep apnea syndrome. INTERVENTION: Uvulopalatopharyngoplasty. MAIN OUTCOME MEASURES: Symptoms and apnea-hypopnea index (AHI) before and after UPPP. Response to treatment defined as a 50% or more reduction in AHI and a postoperative AHI of 10 or less. RESULTS: Reduced prevalence of snoring and daytime sleepiness and reduction in AHI (mean [+/-SD], 40 +/- 26 to 21 +/- 21) at follow-up (P < .001). Sixteen patients (64%) were responders after 6 months and 12 (48%) at the long-term follow-up. Responders had a lower preoperative AHI (25 +/- 7) than did nonresponders (48 +/- 29) (P < .05). None of the 7 patients with preoperative AHI of more than 40 were responders (P < .01). No difference was seen in preoperative body mass index, lung function, ventilatory response to carbon dioxide, computed tomography scan of upper airways, or change in body mass index between responders and nonresponders. CONCLUSIONS: Four to 8 years after UPPP, about half of our patients were clinically and objectively improved. Uvulopalatopharyngoplasty should be reserved for patients with mild or moderate obstructive sleep apnea. After UPPP, long-term follow-up is recommended because some initially successfully treated patients will relapse in the long term.

Female↗
PubMed1996

Thoracic and thoracoabdominal aortic aneurysm and dissection: an investigation based on autopsy.

The city of Malmö (population approximately 230,000) has a fairly stable urban population and a high autopsy rate (83 per cent of all deaths). Autopsy records for the period from 1958 to 1985 were scrutinized and three groups of patients were defined: those with asymptomatic thoracic aortic aneurysm (TAA), those with rupture of the thoracic aorta, and those with dissection. The findings were used to calculate prevalence and incidence according to age and sex. Asymptomatic TAA was found in 205 patients (109 men). There was a predominance of men in higher age groups and about 5 per cent of the lesions were thoracoabdominal. Rupture of the thoracic aorta was the cause of death in 63 patients; no age difference between the sexes was observed. Death as a result of dissection occurred in 216 patients, women dying on average 7 years later than men. The incidence of rupture was 0.9 per 100,000 for men and 1.0 per 100,000 for women; the incidence of dissection was 3.2 per 100,000 for both sexes. Prevalence and incidence of fatal complications of TAA are low; this may influence decisions about where these patients should be treated.

Adolescent↗
PubMed1996

Expression of serine/threonine kinase receptors including the bone morphogenetic factor type II receptor in the developing and adult rat brain.

The expression patterns of serine/threonine kinase receptors in the central nervous system of the developing and adult rat were studied by in situ hybridization. The recently cloned bone morphogenetic factor receptor type II (BMPR-II) was compared with the ActR-II and several type I receptors including ActR-I, ActR-IB, BMPR-IA, BMPR-IB and TbetaR-I. We found that these receptors are spatially and temporally regulated. As early as embryonic day 11 (E11), BMPR-II mRNA was expressed in the neuroepithelium in brain and spinal cord. At E15, the expression of ActR-II mRNA was stronger than that of BMPR-II in the spinal cord, followed in intensity by the expression of ActR-I, ActR-IB, BMPR-IA, BMPR-IB and TbetaR-I mRNA. The BMP type I receptors were expressed only in the ependymal epithelium and in the sympathetic ganglia at E15. Many of the examined receptor mRNAs were expressed at peak levels in the brain around birth. In the adult brain, mRNA for BMPR-II was expressed in different patterns together with ActR-II and ActR-I. Thus, BMPR-II mRNA was found in neurons of the cortex, dentate gyrus, hippocampus, habenula and substantia nigra. ActR-II, ActR-I, ActR-IB and, weakly, TbetaR-I were all expressed in the dentate gyrus. In contrast mRNA for BMPR-IA and BMPR-IB was not found in the adult brain. It is suggested that the expressed receptors may mediate actions of members of the TGFbeta superfamily, e.g. BMPs, controlling the development and plasticity in the nervous system.

Age Factors↗
PubMed1996

Prognosis in elderly men with screening-detected abdominal aortic aneurysm.

OBJECTIVES: To study the natural course of screening-detected symptomless abdominal aortic aneurysm (AAA) in elderly men. SETTING: Malmö, a city in southern Sweden with 230,000 inhabitants and a single referral hospital. MATERIALS: 423 seventy-four-year-old men, randomly selected from the population and belonging to the prospective population study "Men born in 1914", were invited. 343 underwent AAA screening, whereas 80 declined or had moved. CHIEF OUTCOME MEASURES: Five year all cause mortality in relation to participation in and findings at ultrasound screening for AAA. MAIN RESULTS: An abdominal aortic aneurysm was present in 38 (11%) out of 340 men who underwent screening and who had a native aorta. During 5 years of follow-up, one third (13/38) of these men died; 7 from myocardial infarction and 3 from stroke. The mortality rate in men with AAA was 80.2/1000 person years; twice as high as it was in men without AAA (39.4/1000 person years; p = 0.018). Six men underwent AAA surgery. None of them died from aneurysm rupture. However, aneurysm surgery did not reduce the total mortality rate in these men. The highest mortality rate, 91.9/1000 person years, was found in the men who did not participate in the screening. CONCLUSIONS: It is our conclusion that screening for early detection and intervention is of questionable value from a public health perspective.

Aged↗
PubMed1995

Expression of activin receptors type I and II only partially overlaps in the nervous system.

In situ hybridization was used to localize mRNA encoding two cooperative serine/threonine kinase receptors. Activin receptor IIA mRNA in the adult rat brain is highly expressed in the dentate gyrus, in the pyramidal neurones of CA3 and CA1, in the entorhinal cortex, in the cortical amygdaloid nucleus and in the amygdalohippocampal area. In the E16 rat embryo, labelling was found in the dorsal root ganglion neurones and in the spinal cord. Activin type I receptor (ALK-2/R-1) labelling was also localized to the hippocampal formation but with an even distribution over the granular cells of the dentate gyrus, the CA3 and CA1 pyramidal neurones, while no labelling was found in the entorhinal or amygdaloid areas. In the E16 rat no neuronal labelling was found. The incomplete overlap of these two expression patterns suggests that these receptors may locally have other partners for forming signalling receptor complexes.

Activin Receptors↗
PubMed1994

Excessive daytime sleepiness and fatigue in nonapnoeic snorers: improvement after UPPP.

Even in the absence of sleep apnoea, heavy snoring may be a cause of excessive daytime sleepiness (EDS) and fatigue. The aim of this investigation was to study whether uvulopalatopharyngoplasty (UPPP) is effective in relieving snoring and excessive daytime sleepiness in nonapnoeic snoring patients. UPPP was assessed in 155 nonapnoeic, snoring patients (136 men and 19 women, mean age 45 yrs). Postoperative evaluation was made after 3 months in 105 patients, and after 12 months in 50 patients. Fifty four patients were evaluated after both 3 and 12 months. In 49 patients, a further evaluation was made after 2 yrs. The results were compared with those of 76 conservatively-treated, nonapnoeic, snoring patients, who were reinvestigated 12 months after their initial examination. The proportion of patients with frequent loud snoring had decreased postoperatively from 96 to 18%. A highly significant improvement was reported in EDS and daytime fatigue. The proportion of patients who reported problems staying awake when driving had decreased from 29 to 7%, and the number who felt rested when awakening in the morning had increased from 23 to 78 after the operation. The patients in the UPPP group had somewhat more severe symptoms before treatment than those treated conservatively. One year after treatment the situation had been reversed, with significantly more snoring and excessive daytime sleepiness in the conservatively-treated group. In conclusion, these results indicate that UPPP is effective in relieving snoring and EDS in nonapnoeic snorers.

Adult↗
PubMed1993

Natural history of abdominal aortic aneurysm detected by screening.

A group of 88 patients with abdominal aortic dilation found in four ultrasonographic screening studies was followed prospectively by repeated ultrasonography. The initial aortic diameter ranged between 18 and 70 mm. In 19 patients (22 per cent) the aortic diameter exceeded 39 mm. The mean (s.e.m.) annual expansion rate of dilatations < 40 mm in diameter was 0.8 (1.2) mm; among those > or = 40 mm it was 3.3 (1.2) mm. The expansion rate increased with increasing initial diameter. Thirty-eight patients died; the overall mortality rate in the group was high in comparison with an age- and sex-matched population. One patient died after elective aneurysm surgery but none died from a ruptured aneurysm. In conclusion, in about 80 per cent of dilatations found in screening studies the aortic diameter was < 40 mm, with a low risk of rupture. One annual rescanning of an aneurysm < 35 mm in diameter is sufficient; a high overall mortality rate must be expected.

Aged↗
PubMed1993

Ruptured abdominal aortic aneurysm: a population-based study.

PURPOSE: The purpose of this study was to make an analysis of all ruptured abdominal aortic aneurysms in a defined population. METHODS: An epidemiologic analysis of ruptured abdominal aortic aneurysms (AAAs) was made in an urban population during a 16-year period. The study was retrospective and covered a demographically defined population of 230,000 inhabitants in the city of Malmö, Sweden. Reports of all identified ruptured AAAs in Malmö from 1971 to 1986 were analyzed. The autopsy rate in the city was 85% during this period. RESULTS: Ruptured AAAs were found in 5.6 of 100,000 persons (8.4/100,000 men and 3.0/100,000 women). No increase was found during the study period after age and sex standardization. The age-specific incidence was highest (113/100,000) in men 81 to 90 years old and (68/100,000) in women older than 90. The number of surgical interventions increased among men but not among women and the surgical mortality rate decreased from 86% to 43%. The overall mortality rate for ruptured AAA was 88%. The most common symptoms were abdominal pain and loss of consciousness. CONCLUSIONS: The validity of the study was based on a high autopsy rate. The incidence of aneurysm rupture was not low compared with other Scandinavian studies, but was low in comparison with studies from the United Kingdom. No increase in standardized rupture incidence was found. To substantially decrease the total mortality caused by rupture, operation must be performed before rupture.

Adult↗
PubMed1993

Expansion pattern and risk of rupture of abdominal aortic aneurysms that were not operated on.

OBJECTIVE: To analyse the outcome of selective management of patients with abdominal aortic aneurysms, the expansion patterns of the aneurysms, and the factors that influenced the rate of rupture. DESIGN: Retrospective study. SETTING: Malmö General Hospital, Lund University, Malmö, Sweden. SUBJECTS: 155 patients (96 men and 59 women) with abdominal aortic aneurysms who were not selected for operation for whatever reason were included in the study immediately after their first ultrasound scan. MAIN OUTCOME MEASURES: Mortality, expansion rate (mm/year) measured on ultrasound scan, and rate of rupture of aneurysm. RESULTS: Median aneurysmal diameter was 40 mm (range 20-80), and length (n = 106) 70 (range 28-140). The patients were followed up for a median of 3.4 years (range 0-10.2). A total of 107 patients died and in 21 the aneurysms ruptured (4 were operated on and survived). Thirteen patients were re-evaluated and operated on electively. Ultrasonography was repeated in 98 patients, the median expansion rates (mm/year) were 3.1 (diameter) and 1.9 (length). There was a significant linear relationship between initial size (diameter and length) and rate of expansion of diameter. The risk of rupture was greater in larger aneurysms that were expanding more quickly. The cumulative mortality was not affected by the 21 aneurysms that ruptured. CONCLUSION: Selective management of patients with aortic aneurysms is justified.

Aged↗
PubMed1992

Prevalence of abdominal aortic aneurysm in the offspring of patients dying from aneurysm rupture.

The prevalence of abdominal aortic aneurysm (AAA) is high in the brothers of patients with aneurysm. A genetic component in the development of AAA has, therefore, been postulated. In this study the offspring of patients who had died from AAA rupture were invited to undergo ultrasonography of the abdominal aorta. The attendance rate was 69 per cent. Thirty-nine sons of median age 60 (range 45-75) years and 23 daughters of median age 62 (range 42-80) years were examined. Abdominal aortic dilatation was found in eight men and one woman. The presence of aortic dilatation in these nine cases was not related to age, hypertension, smoking or symptoms of occlusive arterial disease. It is concluded that the sons of those who have died from ruptured AAA constitute a high-risk group for the development of this condition and should be considered for further screening.

Aged↗