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Biomedical subjects

P Wahlberg

Publications and source records attributed to P Wahlberg.

At least 19 recordsLinked to original sources
PubMed1996

Retinoic acid concentrations in patients with squamous cell carcinoma of the head and neck.

The serum concentrations of all-trans (atRA) and 13-cis (13cRA) retinoic acid were determined by high performance liquid chromatography in 27 patients with squamous cell carcinoma of the head and neck and in 80 healthy controls. This investigation seemed relevant as ethanol is an aetiological factor in these cancers and has been suggested to interfere with the synthesis of atRA. Neither the serum concentration of atRA nor that of 13cRA differed between patients and controls. The serum atRA concentration did not differ between fasting and non-fasting patients, but the serum 13cRA concentration was significantly higher in non-fasting than in fasting patients, probably due to the dietary retinoid content.

Adult↗
PubMed1994

Combined doxorubicin, hyperfractionated radiotherapy, and surgery in anaplastic thyroid carcinoma. Report on two protocols. The Swedish Anaplastic Thyroid Cancer Group.

BACKGROUND: Anaplastic carcinoma of the thyroid (ACT) rarely can be cured, but every effort should be made to improve prognosis and, above all, prevent death due to suffocation or large local tumor ulceration. METHODS: From 1984 to 1992, 33 consecutive patients with ACT were treated prospectively according to a combined treatment program consisting of hyperfractionated radiotherapy, doxorubicin, and debulking surgery. Preoperative radiotherapy was administered to a target dose of 30 Gy and postoperatively to a total dose of 46 Gy. Radiotherapy was performed 5 days a week. The daily fraction was 1.0 Gy x 2 until 1988, after which it was 1.3 Gy x 2. Otherwise, the therapy remained unchanged. Twenty milligrams of doxorubicin were administered intravenously per week. Debulking surgery was possible in 23 patients (70%). RESULTS: No patient failed to complete the protocol because of toxicity. There were no signs of local recurrence in 16 patients (48%). In only eight patients (24%) was death attributed to local failure. In four patients, survival with no evidence of disease exceeded 2 years. Improvement in local tumor control was marginally significant (P = 0.08) in the 17 patients treated in the latter part of the study, with no sign of local disease in 11 patients and deaths due to local failure in only 2 patients. The improved local control could not be attributed to any differences between the two series. CONCLUSION: Combination modality treatment of ACT is feasible and effective despite the patients' advanced age and locally advanced disease. There was a tendency for local control to be improved after accelerated radiotherapy.

Aged↗
PubMed1994

Treatment of late Lyme borreliosis.

The aim of this study was to develop a treatment for late Lyme borreliosis and to compare the clinical results with serological findings before and after treatment. It was done in the Aland Islands (population 25,000), a region endemic for Lyme borreliosis. The patients were the first consecutive 100 patients from the Aland Islands with late Lyme borreliosis. They were followed for at least 1 year after treatment. The clinical results of treatment were compared with results of analyses of flagellar IgG antibodies to Borrelia burgdorferi done at the time of diagnosis before treatment and up to 12 months afterwards. Short periods of treatment were not generally effective. The outcome was successful in four of 13 treatments with 14 days of intravenous ceftriaxone alone, in 50 of 56 assessable treatments with ceftriaxone followed by 100 days of amoxycillin plus probenecid, and in 19 of 23 completed treatments with ceftriaxone followed by 100 days of cephadroxil. Titres of IgG antibodies to B. burgdorferi flagella declined significantly after 6 and 12 months in the patients who had successful treatments. All patients whose final titres were less than 30% of the initial titre were in the successful group. Their titres usually remained above the upper limit of normal for a long time but a decline to a value of less than 30% of that before treatment was always a sign of cure.

Anti-Bacterial Agents↗
PubMed1993

Late Lyme borreliosis: epidemiology, diagnosis and clinical features.

Lyme borreliosis is endemic in the Aland Islands. Exposure of the inhabitants to bites of the tick Ixodes ricinus is heavy. The purpose of this study was to describe symptoms and signs of patients with late Lyme borreliosis in this area, and to correlate the findings with the epidemiological setting. The first 100 consecutive patients with late Lyme borreliosis found in the region since 1984 are included in this study. Neurological, articular and muscular symptoms and signs dominate. General screening for Lyme disease is not recommended in the area due to uncertainty about how to deal with seropositive healthy persons in this heavily exposed population. The recognition and prompt treatment of erythema migrans and other manifestations of primary Lyme borreliosis is important in order to avoid the late stages of the disease. Treatment of all those suffering tick-bites with an antibiotic would be an option in view of the incidence of infected ticks, but cannot be considered because tick-bites are extremely common among the inhabitants. The region would be suitable for general immunization against Borrelia burgdorferi if the means for doing this becomes available in the future.

Adolescent↗
PubMed1993

[Message from Lyme].

The background to the discovery of Lyme disease teaches a salutary lesson. The symptoms and signs of this disease had been observed by doctors for a century, particularly in the Scandinavian countries, without anybody being able to draw the right conclusions. The first patients were identified in the USA by their relatives or by themselves. Recognition of their plight by the medical profession was chiefly due to the patients' tenacity. We must remember to pay attention to what patients tell us; they may often be right, even when they seem to be wrong. Where fact and theory are incompatible, it is theory, not fact, that needs to be amended. In all likelihood, we all from time to time observe disorders in our patients that are inconsistent with established scientific models, but which we nevertheless attempt to squeeze into these models. Such an approach is not uncommon in the history of medicine. The message from Lyme calls for humility and reflexion.

Attitude of Health Personnel↗
PubMed1990

Incidence of tick-bite in man in Aland Islands: reference to the spread of Lyme borreliosis.

The common tick Ixodes ricinus is a vector both for the virus of tick-borne viral encephalitis (Kumlinge disease, KD) and of Borrelia burgdorferi (Lyme borreliosis, LB). Bites of the tick are believed to be common in Aland, an island province of Finland in the Baltic Sea. KD has been seen there for many years, and cases of LB have been diagnosed lately. The purpose of this study was to find the incidence of tick-bite among the population with possible implications for the spread of LB. A questionnaire was sent to 561 persons greater than 8 years of age out of a total of 21,281 in order to record tick-bites and erythema chronicum migrans (ECM). The number of answers was 519 (92.5%). 441 persons (85%) had been bitten by ticks, 146 greater than 10 times. 14 probands had had ECM, 73 other rashes around the tick-bite. It is concluded that tick-bites are very common among the population, and thus conditions are favourable for the spread of any tick-borne infection such as LB. The number of patients with secondary or tertiary LB diagnosed in the area is presently 17. It is likely that there are many undetected cases in the area.

Animals↗
PubMed1989

A relationship between retinol and cellular retinol-binding protein concentrations in human squamous cell carcinomas.

The retinol and retinyl ester concentrations in human xenografted squamous cell carcinomas, with various concentrations of cellular retinol-binding protein (CRBP), were studied, as well as the in vivo uptake and esterification in these tumours of labelled retinol, presented as a complex with plasma RBP. The mean retinol concentration in the different tumours was in the range 3.7-6.2 nmol/g protein, and the mean CRBP concentration was between 16 and 69 nmol/g protein. There was a statistically significant correlation between the retinol and the CRBP concentrations in the same tumour (P less than 0.001; r = 0.622). Calculation of the maximal extent of retinol-saturation of CRBP showed low values (range: 9-26%). Retinyl palmitate, the predominant retinyl ester, comprised approx. 70% of the retinyl esters in the tumours. There was no correlation between the concentration of CRBP and that of retinyl palmitate. The uptake of [3H]retinol from intravenously injected retinol-RBP complex was similar in the four human squamous cell carcinomas studied, and not related to their CRBP concentration. 20% of the radioactivity in tumour specimens was lipid soluble, as compared to 96% in liver specimens, showing that in the former a higher fraction metabolised to polar compounds. Taken together, our results suggest that in these squamous carcinoma cells, factors other than cellular CRBP content are the major determinants of net cellular uptake and esterification of retinol. The cellular retinol concentration, on the other hand, appears proportional to CRBP content.

Carcinoma, Squamous Cell↗
PubMed1989

Tick-borne viral encephalitis in Finland. The clinical features of Kumlinge disease during 1959-1987.

During 1959-1987, 126 patients in Aland Islands and main Finland had serologically verified infections with the virus of tick-borne encephalitis (Kumlinge disease). The most useful test for specific virological diagnosis was haemagglutination inhibition-IgM (HI-IgM). Most cases were from Aland Islands and nearby south-western main Finland. Two of the infections were imported. There were three laboratory infections and two transfusion infections. The disease occurred mainly from July to September. Detailed hospital records of 108 of the patients could be obtained. Ninety-five per cent of the patients had headaches, 82% had lymphocytosis of the cerebrospinal fluid, and 81% had high fever. Forty-four per cent had a confirmed biphasic course of disease. Seventeen per cent were severely ill. There were no deaths. The sequels were psychic irritability and fatigue for up to 1 year. There were eight cases of paresis, two of which became permanent.

Encephalitis Viruses↗
PubMed1989

[Hypothyroidism in the elderly--a concealed disease].

Hypothyroidism in the elderly seldom corresponds to the text-book picture of this disorder. Symptoms and signs develop insidiously, and may easily be taken for the result of arteriosclerotic disease. Screening for hypothyroidism in elderly people is advocated, and serum-TSH is recommended as the primary investigation for such screening. Substitution with thyroxine must be started cautiously and with very small doses. Healthy people with subclinical hypothyroidism should be observed for the possible occurrence of symptoms and signs.

Age Factors↗
PubMed1988

Quantitation and localization of cellular retinol-binding protein in squamous-cell carcinomas of the cervix uteri and of the oral cavity.

The concentration of cellular retinol-binding protein (CRBP) was determined by radioimmunoassay in biopsies of normal mucosa and squamous-cell carcinomas of cervix uteri from 30 women. The tumour tissues contained significantly higher concentrations of CRBP (median = 120 micrograms/g protein) than normal mucosa (median = 32 micrograms/g protein). The distribution of CRBP in normal mucosa and squamous-cell carcinomas from cervix uteri and from oral cavity was evaluated by immunohistochemical techniques. In tissue sections of normal epithelium from the cervix uteri and the oral cavity, the maturing keratinocytes in the prickle-cell layers were moderately or strongly stained when antiserum against CRBP was used, while the proliferating cells in the basal-cell layer were stained only lightly if at all. Squamous-cell carcinomas of the cervix uteri and the oral cavity presented much the same picture. The observed difference in CRBP concentration between squamous-cell carcinomas and normal squamous-cell mucosa may therefore be more quantitative than qualitative.

Adult↗
PubMed1986

Studies of cellular retinol-binding protein (CRBP) in squamous-cell carcinomas of the head and neck region.

Cellular retinol-binding protein (CRBP) concentration was determined by radioimmunoassay in biopsies from normal mucosa and squamous-cell cancers of the head and neck region in 26 patients. The plasma concentrations of retinol, retinol-binding protein (RBP), prealbumin, albumin, orosomucoid and alfa1-antitrypsin were also determined. In all patients the tumours contained significantly higher concentrations of CRBP (median = 185 micrograms/g tissue protein; range: 27-1,017 micrograms/g) than normal mucosa (median = 14 micrograms/g tissue protein; range 6-97 micrograms/g). CRBP could not be detected in patient plasma. The tumor/normal mucosa CRBP concentration ratio showed a significant inverse correlation to a histopathological malignancy grade score evaluating the tumour-host relationship, suggesting that tumours with high CRBP relative to normal mucosa are biologically less aggressive. Tumour CRBP showed no correlation either to CRBP concentration in normal mucosa, or to plasma retinol or plasma retinol-binding protein concentration. CRBP concentration in normal mucosa, however, showed a significant correlation to plasma retinol-binding protein concentration. Most of the patients had low levels of plasma retinol and retinol-binding protein compared to matched controls. Whether this has any relationship to the development of the tumour, or whether the active inflammation induced by the cancer leads to a low plasma retinol concentration, is unknown.

Adult↗
PubMed1985

Treatment of hyperthyroidism with standard doses of radioiodine aiming at ablation.

Sixty patients with hyperthyroidism were treated with standard doses of 131I during 1969-83 in our department. The doses were 10-25 mCi (370-920 MBq), mostly 15 mCi (550 MBq). 38 of the patients have become hypothyroid, mostly within one year after treatment. There were 3 early relapses of hyperthyroidism; these patients became hypothyroid within one year after an additional dose of radioiodine. All hypothyroid patients had early substitution with l-thyroxine before overt clinical symptoms and signs had developed. There were no late relapses of hyperthyroidism. 15 patients had died during the follow-up; all were euthyroid or hypothyroid with adequate substitution. 28 of the 60 patients have been followed for 5-14 years, 14 for 2-5 years, 7 for 1-2 years and 10 for less than one year. Standard dose 131I treatment offers certain advantages compared with attempted individualized treatment. Late hypothyroidism after individualized dosage may be difficult to anticipate and detect, whereas early hypothyroidism after ablative standard dose treatment is easy to detect and control. Generally speaking, hypothyroidism is not to be regarded as a complication of radioiodine treatment for hyperthyroidism, but as its natural end result. The fixed dose schedule is especially well suited for regions where hyperthyroidism with no goitre or a small goitre is common.

Adult↗