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J Wikström

Publications and source records attributed to J Wikström.

At least 37 records · Page 2Linked to original sources
PubMed1997

Genomewide scan of multiple sclerosis in Finnish multiplex families.

Multiple sclerosis (MS) is a neurological, demyelinating disorder with a putative autoimmune etiology. It is thought to be a multifactorial disease with a complex mode of inheritance. Here we report the results of a two-stage genomewide scan for loci predisposing to MS. The first stage of the screen, with a low-resolution map, was performed in a selection of 16 pedigrees collected from an isolated Finnish population. Multipoint, non-parametric linkage analysis of the 328 markers did not reveal statistically significant results. However, 10 slightly interesting regions (P = .1-.15) emerged, including our previous findings of the HLA complex on 6p21 and a putative locus on 5p14-p12. Eight of these novel regions were further analyzed by use of denser marker maps, in the second stage of the scan. For the chromosomal regions 4cen, 11tel, and 17q, the statistical significance increased, but not conclusively; for 2q32 and 10q21, the statistical significance did not change. Accordingly, genotyping of the high-density markers in these regions was performed, and the data were analyzed by use of two-point, parametric linkage analysis using the complete pedigree information of the 21 Finnish multiplex families. We detected suggestive evidence for a predisposing locus on chromosomal region 17q22-q24. Several markers on 17q22-q24 yielded positive LOD scores, with the maximum LOD score (Zmax) occurring with D17S807 (Zmax = 2.8, theta = .04; dominant model). Interestingly, a suggestive linkage between MS and the markers on 17q22-q24 was also revealed by a recent genomewide scan in MS families from the United Kingdom.

Autoimmune Diseases↗
PubMed1997

A prospective study of injuries in licensed floorball players.

Injuries occurring among 457 licensed floorball players in the Swedish National League were analysed prospectively during the season from 1993 to 1994. Fifty-one (11%) players sustained 58 injuries. The majority (76%) of the injuries were due to trauma mostly during the gama (55%). Twenty-three (52%) of the traumatic injuries were caused by an opponent or a stick. Ankle sprain (35%) was the most common diagnosis. Injury severity classified with regard to time of absence from sport participation were similarly distributed for minor (36%), moderate (29%) and major (35%) injuries. The total rate of injury was 2.5 per 1000 hours for female and 2.6 for male players. Although this rate is lower than for contact sports like soccer and ice-hockey, we feel that further investigation of floorball injuries and improvement of protection devices would be valuable.

Adult↗
PubMed1996

A putative vulnerability locus to multiple sclerosis maps to 5p14-p12 in a region syntenic to the murine locus Eae2.

Multiple sclerosis (MS) is a chronic inflammatory disorder characterized by multifocal damage of myelin in the central nervous system (CNS). The prevalence of this putative autoimmune disease is 0.1% in individuals of northern European origin. Family, adoption and twin studies implicate genetic factors in the aetiology. MS is widely speculated to be a multifactorial disorder with a complex mode of inheritance. Despite many studies of candidate genes, only an association with HLA-DR2-DQ6 has been generally detected, and the number of susceptibility genes remains unknown. The chronic variant of experimental allergic encephalomyelitis (EAE), a T-cell mediated autoimmune disease in rodents, represents a relevant animal model for MS given the chronic relapsing disease course and inflammatory changes of CNS observed in these demyelinating disorders. Susceptibility to EAE is also influenced by the major histocompatibility complex (MHC). Human syntenic regions to murine loci predisposing to EAE were tested as candidate regions for genetic susceptibility of MS. Three chromosomal regions (1p22-q23, 5p14-p12 and Xq13.2-q22) were screened in 21 Finnish multiplex MS families most originating from a high risk region in western Finland. Several markers yielded positive lod scores on 5p14-p12, syntenic to the murine locus Eae2. Our data provide evidence for a predisposing locus for MS on 5p14-p12.

Animals↗
PubMed1993

Reappraisal of HLA in multiple sclerosis: close linkage in multiplex families.

Although association between multiple sclerosis (MS) and HLA-DR2,DQw6 has been well documented, family studies have not established linkage to HLA. Here we have (1) carried out an HLA-DQA1, -DQB1 association study in unrelated patients and controls, and (2) analyzed linkage between MS and HLA in multiplex families using both nonparametric and parametric methods. The subjects and families were derived from the genetically homogeneous Finnish population, and 14 of the 21 families came from a high-risk area with exceptional familial clustering of cases. In the association study, the frequencies of the alleles DQA1*0102 and DQB1*0602 (encoding DR2-associated DQw6 antigen) were significantly increased in MS patients compared to controls. In the families, we observed that the segregation of MS with DQA1*0102 and DQB1*0602 was not HLA haplotype specific, i.e., these alleles were frequently transmitted to MS relatives on different parental haplotypes. Consequently, we found strong evidence for linkage between MS and HLA only when the haplotype-independent segregation of the MS-associated alleles was controlled. This observation may partially explain the lack of linkage evidence in previous family studies. The highest LOD scores were obtained to the DQA1 locus (LODmax = 6.43, theta = 0.00). The linkage analyses suggest that both the patients' HLA haplotypes may contribute to MS susceptibility. In one of a patient's haplotypes, the susceptibility locus was closely associated with DQA1*0102 and DQB1*0602, whereas in the other haplotype no association with any of the individual candidate loci was found. These results demonstrate, for the first time, a close linkage between MS and HLA, and raise the possibility of distinct HLA-linked susceptibility genes in MS.

Base Sequence↗
PubMed1993

Effect of operative choledochoscopy after choledocholithotomy on the incidence of retained stones.

OBJECTIVE: To see whether the introduction of operative choledochoscopy would lower the incidence of retained stones in the common bile duct. DESIGN: Retrospective study. SETTING: Mora Hospital, Mora, Sweden. SUBJECTS: 176 patients who underwent exploration of the common bile duct from 1984-1991. INTERVENTIONS: After exploration of the common bile duct, 109 of the 176 patients underwent choledochoscopy; the remaining 67 had the choledochotomy closed over the T-tube, and an operative cholangiogram done. RESULTS: Six of the 109 patients (6%) who have had common bile duct exploration followed by choledochoscopy were found to have residual stones and in 1 of those 6 no stones had been found on the exploration of the duct. Ten of the 67 patients (15%) who had choledocholithotomy followed by an operative cholangiogram had residual stones, and in two of those no stones had been found on exploration. The annual frequency of choledochoscopy after exploration of the common bile duct increased from 50% to 80% over the period. CONCLUSION: We recommend that operative choledochoscopy should always be done after exploration of the common bile duct to reduce the incidence of retained stones.

Endoscopy, Digestive System↗
PubMed1992

Genetic susceptibility to multiple sclerosis linked to myelin basic protein gene.

Genetic factors have been implicated in the aetiology of multiple sclerosis (MS), but the genes conferring susceptibility to MS have not been identified. We carried out genetic linkage and association analyses by studying polymorphism of the myelin basic protein (MBP) gene on chromosome 18, a candidate gene for MS, in 21 MS families, 51 additional unrelated patients with definite MS, and 85 controls. All subjects were Finnish, and 14 of the families were from an area with an exceptional familial clustering of MS. Magnetic resonance imaging (MRI) was used to examine subclinical disease in symptom-free family members. In the association analysis, the allele frequencies between MS patients and controls differed significantly, p = 0.000049), the difference being attributable mainly to a higher frequency of a 1.27 kb allele among patients. In the linkage analysis, based on an autosomal dominant model and penetrance 0.05, a maximum LOD score of 3.42 (theta = 0.00) was obtained when patients with optic neuritis and their symptom-free siblings with abnormal MRI findings were classified as "affected". When these subjects were classified as "unknown" the maximum LOD scores ranged from 2.99 to 3.25 (theta = 0.00). The results suggest that in this population genetic predisposition to MS is closely linked to the MBP gene and that polymorphism at the MBP locus or an adjacent locus has a role in the aetiology of MS.

Adult↗
PubMed1992

Familial multiple sclerosis: MRI findings in clinically affected and unaffected siblings.

Subclinical demyelinating lesions may occur in the brains of asymptomatic individuals, and the first-degree relatives of multiple sclerosis (MS) patients are at particular risk. Clinical and MRI examinations were performed in nine sibships from families with two or more cases of MS. These included 14 patients with clinically definite MS, three patients with clinically probable MS, and 27 asymptomatic siblings. Systematic criteria were applied to MRI interpretations to increase their specificity for MS. Thirteen (76%) of the 17 patients with MS showed lesions suggesting MS. Lesions were also found in six (38%) of the 16 asymptomatic siblings under age 50 and in eight (73%) of the 11 over age 50. Judged by stringent criteria, the lesions of only three (11%) of the 27 asymptomatic siblings were considered to be due to demyelination. The results demonstrate the occurrence of subclinical demyelination in asymptomatic siblings of MS patients and stress the importance of clinical follow up and MRI studies of the first-degree relatives when classifying them as healthy in family studies.

Adult↗
PubMed1989

Primary survival and prosthetic fitting of lower limb amputees.

During the period 1984-1985 amputation of the lower limb at a level potentially requiring a prosthesis was performed on 577 patients in 16 operative units. The mean age was 75.7 years for females and 68.1 for males. The most common site of the amputation was above the knee (49.9%). The majority of amputations (93.8%) were performed for vascular diseases and diabetes. Survival figures showed that 25.5% of amputees died within 2 months of amputation, 60.7% were alive after one year and 43.2% after two years. Out of a total of 577 patients, 26.9% were fitted with a prosthesis. Out of below-knee and above-knee amputees surviving over 2 months, 61.5% and 27.2% respectively were fitted with a prosthesis. There were markedly fewer prosthetic fittings in the over-60 age group. Diabetic patients of both sexes were fitted with a prosthesis more often than arterio-sclerotic patients. Among tumour patients 82.4% received a prosthesis. In the study area more emphasis must be put on the concept of preserving the knee joint and preoperative assessment of vascular patients for selection of amputation level. Every effort must be made to avoid delay in the postoperative mobilization and rehabilitation. Prosthetic fitting of amputees could be improved by better liaison between surgical unit and specialized rehabilitation unit and by closer team approach of amputee care.

Aged↗
PubMed1988

A follow-up study of very low field MRI findings and clinical course in multiple sclerosis.

Seventy-three consecutive patients with definite multiple sclerosis (MS) were examined with very low field (0.17 and 0.02 tesla) magnetic resonance imaging (MRI) of the brain. Fifty-seven patients were examined a second time after 6 months, 41 patients a third time after 1 year, and 25 patients a fourth time after 2 years. The initial finding was abnormal in 57/73 patients (78%). The number of lesions increased with age, duration of disease, and increasing disability. Plaques were more numerous in progressive than in remitting MS. Of the patients with abnormal MRI 65% had more than 3 lesions, and in 82% lesions were smaller than 2.5 cm in diameter. After follow-ups of 1 year and 2 years the size of MRI lesions remained unchanged in 55% and 64%, respectively. Unchanged plaque numbers were found in 72% and 60%. Unchanged MRI was most common among patients with remitting MS who were in a stable phase. Decrease in size and disappearance of plaques correlated well with clinical remissions. Increase in size was rare even during relapses. New plaques could appear during all phases of clinical course although they reflected better a relapse of remitting or progressive disease.

Adult↗
PubMed1988

Dementia in medical wards.

Patients aged 65 years and over admitted to one Department of Medicine in a University Hospital were evaluated for the frequency and types of dementia, and for the greater workload caused by the demented patients to the hospital. The frequency of moderate and severe dementia among consecutively admitted medical inpatients (N = 282) of all age groups was 12.1%. In the age-group 65-69 years it was 5.7%, and among the patients aged 80 and over 20.7%. Of all the patients at the wards in a one-day sample (N = 85), 40% were moderately or severely demented. Patients with vascular dementia constituted 69.4%, those with primary degenerative dementia 16.1%, and those with dementia due to specific causes 14.5% of all demented patients. The demented patients needed more daily nursing care and their mean hospitalization time was longer than that of the non-demented patients.

Aged↗
PubMed1987

Short Portable Mental Status Questionnaire as a screening test for dementia and delirium among the elderly.

Pfeiffer's Short Portable Mental Status Questionnaire (SPMSQ) is a brief screening test for organic brain syndromes. The validity of the SPMSQ was evaluated in a random sample of 119 community residents and 282 consecutively admitted medical inpatients. The SPMSQ proved to be a sensitive and specific screening test for moderate to severe dementia both in the community and hospital. Using the cut-off point (number of errors accepted) of three errors, the sensitivity of the test was 86.2% and the specificity 99.0% among medical inpatients. The percentages in the community sample were 66.7% and 100%, respectively. The validity of the SPMSQ was not as good for delirium because of its variable clinical picture. For screening purposes lower cut-off points than previously recommended should be used: three errors for dementia and two errors for delirium. Among Finnish elderly people it was not necessary to use correction for education in the SPMSQ.

Aged↗
PubMed1986

Dementia among medical inpatients. Evaluation of 2000 consecutive admissions.

Two thousand consecutive patients aged 55 years and older admitted to a department of medicine in a large university hospital were examined for the presence of dementia. The occurrence of moderate and severe dementia was 9.1% for all age groups. It increased from 0.8% in the age group from 55 to 64 years to 31.2% in patients aged 85 years and older. Of the demented patients, 41.4% were delirious at admission, and 24.9% of all delirious patients were demented. Patients with vascular dementia constituted 72.4%, those with primary degenerative dementia 23.0%, and those with specific causes 4.6% of all demented patients. The mean hospitalization time for demented patients was significantly longer, and they needed significantly more daily nursing care, when compared with nondemented patients.

Aged↗
PubMed1985

Prevalence of severe dementia in Finland.

A sample of 8,000 subjects to represent the population of Finland aged 30 years and over was used to identify patients with severe dementia; 141 cases were found. The prevalence of all types of severe dementia was 1.8% in the whole study population and 6.7% in the population aged 65 years and over. The prevalence increased with advancing age to 17.3% in the age group 85 years and over. Primary degenerative dementia constituted 50% of all cases; multi-infarct and combined dementia, 39%; and secondary dementia, 11%. Fifty-seven percent of the patients lived in institutions.

Adult↗