[Based on my experience: that is how I treat "prostatitis"].
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Humans↗
Biomedical subjects
S Larsson
Publications and source records attributed to S Larsson.
Control of adenovirus major late gene expression at multiple levels.
Most late adenovirus (Ad) proteins are translated from mRNAs originating from the so-called major late transcription unit (MLTU). These mRNAs are grouped into five families (designated L1 to L5), where each family consists of mRNAs that have co-terminal 3' ends. We have used mutant and wild-type Ad infections to characterize levels at which major late gene expression is regulated. Our results suggest the existence of a novel intermediate stage during a lytic infection where mRNAs from regions L1 and L4 are selectively overexpressed compared to the L2, L3, and L5 mRNAs. Our data suggest that this RNA phenotype reflects the activity of the MLTU at a transient stage immediately following initiation of viral DNA replication. Early during an Ad infection only mRNA from region L1 accumulate. To efficiently accumulate mRNA from regions L1 and L5 both viral DNA replication and late protein synthesis were required. To allow for only viral DNA replication resulted in an extensive premature transcription termination and a preferential mRNA accumulation from regions L1 and L4. The surprising production of L4 mRNA under these conditions was not due to the activation of a novel r-strand promoter located in the vicinity of region L4 or due to a control at the level of RNA transport or stability. Instead our results indicate that in the absence of efficient late protein synthesis 3' end formation occurs preferentially at the L1 and L4 poly(A) addition sites.
Adenoviridae↗
[Bacterial endocarditis--surgical treatment prolongs survival].
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Endocarditis, Bacterial↗
Imaging of dopamine receptors using PET and SPECT.
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Animals↗
Straight leg raising test versus radiologic size, shape, and position of lumbar disc hernias.
In 30 patients with a computed tomography-verified lumbar disc herniation, the relation between the straight leg raising test and the size, shape, and position of the hernia was evaluated before, 3, and 24 months after inception of nonoperative treatment. Hernia size was expressed as an index relating it to the size of the spinal canal. The limitation of the straight leg raising test was not related to size or position of the hernia. Before treatment, straight leg raising was equally restricted in patients with sharply pointed or blunt hernias, but after 3 months straight leg raising was less limited in patients with sharply pointed hernias, whereas after 24 months straight leg raising was regularly normalized. Size index was lower for sharply pointed hernias at all three computed tomography scans. A decrease in hernia size over time, irrespective of shape, was not correlated to a concomitant improvement in straight leg raising. It must be presumed that additional factors, such as inflammatory reactions affecting the nerve roots, are of importance for the magnitude of straight leg raising.
Adult↗
Quantitation of C-reactive protein levels and erythrocyte sedimentation rate after spinal surgery.
C-reactive protein and erythrocyte sedimentation rate were prospectively measured after four types of uncomplicated spinal operations. In all patients, preoperative normal C-reactive protein (less than 10 mg/L) increased, reaching peak levels on the second day after microdiscectomy (46 +/- 21 mg/L) and anterior fusion (70 +/- 23 mg/L), and at the third day after conventional discectomy (92 +/- 47 mg/L) and posterolateral intercorporal fusion (173 +/- 39 mg/L), with normalization in 5-14 days. Peak levels were not related to bleeding, transfusion, operation time, administered drugs, age, or sex. Erythrocyte sedimentation rate increased to peak levels about 5 days after surgery, followed by a slow and irregular decrease, and at 21-42 days after surgery often remained elevated. The rapid decline in C-reactive protein will probably be interrupted by a second rise or persisting elevation if infection occurs. C-reactive protein is presumably a better test than erythrocyte sedimentation rate for early detection of postoperative infection.
Adult↗
Respiratory failure in scoliosis and other thoracic deformities. A survey of patients with home oxygen or ventilator therapy in Sweden.
Registers covering Swedish patients with home ventilator or long-term oxygen therapy were used to study respiratory failure caused by thoracic deformities. In all, 107 patients were studied. Postpolio scoliosis was found in 47 patients. The age of starting therapy varied between 28 and 80 years. Fourteen patients had thoracic deformities other than scoliosis. The mean scoliotic angle was 135 degrees among the patients with scoliosis, and the mean vital capacity was 26% (range, 13-54%) of predicted normal. The yearly demand for home ventilator or oxygen therapy is calculated to three per million inhabitants. No operated patients had respiratory failure, and no patients were found with idiopathic scoliosis and respiratory failure younger than 30 years of age, which may indicate a preventive effect of corrective surgery on the development of respiratory failure.
Aged↗
Long-term follow-up of patients with untreated scoliosis. A study of mortality, causes of death, and symptoms.
The mortality and causes of death in 115 patients (80 women), born 1902-1937, with untreated scoliosis were compared to the expected according to official Swedish statistics. Subgrouping for cause and onset of scoliosis was done. Fifty-five patients had died; 21 of respiratory failure and 17 of cardiovascular diseases. The mortality was significantly (P less than 0.001) increased. The increased risk was apparent at 40-50 years of age. The mortality was significantly increased in infantile (P less than 0.001) and juvenile (P less than 0.01) scoliosis but not in adolescent scoliosis. The mortality was also increased in post-polio scoliosis, scoliosis combined with rickets and scoliosis of unknown etiology indicating an increased mortality in idiopathic scoliosis. Among the surviving patients anti-hypertensive treatment was frequent (23 of 50).
Adolescent↗
Propofol-fentanyl anesthesia compared to thiopental-halothane with special reference to recovery and vomiting after pediatric strabismus surgery.
Forty-four children, ASA physical status I or II, aged 1.5-14 years and admitted for strabismus surgery, were studied. The study compared the postoperative condition after two different anesthesia methods. All children were premedicated with midazolam rectally, received glycopyrrolate i.v. and were then randomised to one of two anesthetic methods: 1) induction with thiopental, maintenance with halothane or 2) induction with propofol supplemented with fentanyl, maintenance with propofol infusion. In both groups, tracheal intubation was performed after vecuronium i.v. and the children were ventilated manually. Peroperatively, patients receiving propofol/fentanyl had more episodes of bradycardia (P less than 0.001). Times to spontaneous breathing and extubation were shorter in the propofol/fentanyl group (P less than 0.05) and there was also a lesser degree of sedation during the first 2 h postoperatively (P less than 0.01). Fewer children in the propofol/fentanyl group vomited postoperatively (P less than 0.05). The apprehension score was higher in the propofol/fentanyl group compared to the thiopental/halothane group (P less than 0.05). We conclude that children undergoing strabismus surgery anesthetized with propofol/fentanyl had more episodes of peroperative bradycardia, a lower incidence of postoperative vomiting and a shorter recovery time, and were more apprehensive during the initial postoperative period than children anesthetized with thiopental/halothane.
Adolescent↗
Remission rate after thymectomy in myasthenia gravis when the bias of immunosuppressive therapy is eliminated.
The clinical course of all 86 myasthenia gravis (MG) patients who were thymectomized at Sahlgrenska Hospital between 1955 and 1980 was evaluated in order to estimate what the rate of complete clinical remission (with or without anticholinesterase medication) would be without immunosuppressive (IS) therapy; 19 of 73 patients without thymoma received IS therapy. A suitable way of dissociating the course after thymectomy from the influence of IS therapy is the Markov method. The calculated probability of remission was 0.18, 0.35, 0.43, 0.53 and 0.56 in the 0-1, 2-3, 4-5, 5-10 and more than 10-year periods after thymectomy. A similar result (53 +/- 7%) was obtained by a life-table method with censoring of IS-treated patients when they received such therapy. Time to remission was significantly shorter for patients with age of MG onset before 35 years. Timing of IS therapy after thymectomy is discussed, considering the post-thymectomy remission rate.
Adult↗
A randomized trial comparing the use of fresh and stored platelets in the treatment of bone marrow transplant recipients.
Patients undergoing allogeneic bone marrow transplantation (BMT) were randomized into two groups. One group (n = 21) received single donor platelet concentrates (PC) that were as fresh as possible, the other group (n = 18) received single donor PC stored for 2 to 5 days. Actual mean storage times for PC were 1.12 +/- 1.25 (mean +/- SD) and 2.67 +/- 1.30 d, respectively (p < 0.001). The total need for platelets during 60 d after BMT in patients receiving fresh PC was 22.1 +/- 17.8 x 10(9) platelet/liter blood volume/d, and for stored PC 29.2 +/- 19.2 x 10(9) platelets/liter blood volume/d (n.s.). A multiple regression analysis of the data showed no correlation between PC storage time and the PC requirement (p = 0.85). Posttransfusion corrected count increment (CCI) at 1 hour was 10.4 +/- 5.1 for PC stored 0-1 d, 10.3 +/- 7.0 for PC stored 2-3 d, and 11.4 +/- 9.2 for PC stored 4-5 d. The corresponding CCI, at 18 h were 6.5 +/- 4.4, 5.4 +/- 3.3 and 6.8 +/- 4.6. We conclude that there is no major difference between fresh and stored single donor PC.
Adolescent↗
Chest x ray films from construction workers: International Labour Office (ILO 1980) classification compared with routine readings.
The extent of agreement between International Labour Office (ILO) and clinical readings of chest x ray films from construction workers was studied. From a survey of 5898 workers 258 subjects with a profusion of small opacities of > or = 1/1 and a stratified sample of subjects with profusion < 1/1 were selected. Only 41% of the films classified as ILO profusion category > or = 1/1 were clinically recorded as non-normal for the parenchyma. The proportion of films recorded as pneumoconiotic (or possibly so) was especially low for irregular opacities (22%), but increased with the profusion category (both rounded and irregular) as well as with the size of rounded opacities (p 3/11, q 12/25, r 3/4). Only with the profusion category > or = 2/1 were most of the films recorded as pneumoconiotic. The specificity and sensitivity were highest in the geographical areas where a few clinical readers had assessed many films each. The proportion of false negative clinical reports was low for circumscribed pleural thickening of the chest wall (9%) and diaphragmatic pleural thickening (6%). For calcified pleural changes and for the combination of diffuse pleural thickening and obliteration of the costophrenic angle, false negative reports were absent. The present study shows an unsatisfactory sensitivity for clinical compared with ILO readings as a means for screening the parenchyma of workers with a risk of pneumoconiosis.
Humans↗
Coexpression of ganglioside antigen Fuc-GM1, neural-cell adhesion molecule, carcinoembryonic antigen, and carbohydrate tumor-associated antigen CA 50 in lung cancer.
With the aid of specific monoclonal antibodies, tumor tissues from 68 patients with lung cancer were examined for their expression of two small cell lung carcinoma (SCLC) antigens, Fuc-GM1 (fucosyl GM1; IV2FucII3NeuAc GgOse4) and neural-cell adhesion molecule (NCAM), and two broader tumor antigens, carcinoembryonic antigen (CEA) and carbohydrate cancer-associated antigen CA 50. Expression of Fuc-GM1 was seen in 75% and NCAM in 78% of the SCLC specimens, but also in 12 and 20% of non-SCLC. Either or both of these antigens were expressed in more than 90% of SCLC and in 25% of non-SCLC. CEA was found in more than 80% of SCLC and non-SCLC. Expression of CA 50 was seen in 65-68% of non-SCLC and SCLC, showing preference for SCLC and lung adenocarcinoma. In SCLC, cellular expression of Fuc-GM1 was generally seen together with NCAM and CA 50, but rarely with CEA. There was considerable inter- and intratumor heterogeneity in the expression of all four antigens. The results suggest that CEA is the antigen of choice for the detection of lung cancer regardless of histotype. In combined analysis of CEA, CA 50, Fuc-GM1 and NCAM, two patterns of antigen expression were recognized that appear to discriminate between SCLC and non-SCLC tumors, respectively. A considerable fraction of SCLC and non-SCLC tumors, however, exhibited similar patterns of antigen expression. The biological and clinical significance of these observations remains to be investigated.
Antibodies, Monoclonal↗
Nasopharyngeal bacterial flora in otitis prone children treated with immunoglobulin.
The present study was undertaken to evaluate possible beneficial effects of regularly given, long term immunoglobulin prophylaxis of children below 2 years of age with recurrent acute otitis media (RAOM). The nasopharyngeal bacterial flora and the frequency of acute otitis media (AOM) and secretory otitis media SOM were studied. Every second of 44 children with 3 or more periods of AOM during the last year received immunoglobulin intramuscularly (Gammaglobulin Kabi 165 mg/l, 0.45 ml/kg b.w.) every third week for 6 months, while the other 22 children served as controls. All children were followed for 12 months. Immunoglobulin prophylaxis neither influenced the nasopharyngeal flora, nor the frequency of AOM or SOM periods. Children with AOM or SOM more often harbored bacterial pathogens in their nasopharynx than children with normal middle ear status. Also, the immunoglobulin prophylaxis did not influence the increased frequency of bacterial pathogens in the nasopharynx of children attending public day care or family day care as compared to those taken care of at home.
Acute Disease↗
Determination of functional kidney volume by single-photon emission computed tomography in patients with insulin-dependent diabetes mellitus.
Functional parenchymal kidney volume was determined by single-photon emission computed tomography (SPECT) for 99mTc-dimercaptosuccinic acid (DMSA) using a rotating gamma camera in phantom experiments and in patients with insulin-dependent diabetes mellitus (IDDM). The results from the patient examinations were corrected according to the phantom studies and were thereafter set in relation to renal haemodynamics, blood pressure, and urinary albumin excretion. Functional parenchymal kidney volume was significantly greater in diabetic patients compared to that of 11 healthy controls (P < 0.003). Urinary albumin excretion was increased and glomerular filtration rate (GFR) per renal parenchymal volume significantly less in patients with a duration of diabetic disease of more than 15 years compared to patients with shorter duration of disease (P < 0.03 and P < 0.05 respectively). Diabetic patients with a GFR of more than 120 ml/min had greater renal parenchymal volume than patients with lower GFR (P < 0.02). Patients with increased GFR, renal plasma flow (RPF), renal blood flow, or filtration fraction had significantly greater functional parenchymal volume than the healthy subjects (P < 0.01 for all comparisons). We conclude that by application of SPECT for DMSA we were able to show that IDDM patients have greater renal parenchymal volumes than healthy subjects. GFR/kidney volume was increased in IDDM patients with a duration of disease of < 15 years compared to patients with long-standing diabetes. The SPECT technique seems suitable for prospective long-term follow-up studies of functional kidney volume in IDDM patients.
Adult↗
Technical options in reconstruction of large mediastinal veins.
Twelve patients who underwent graft replacement of the large mediastinal veins were reviewed. A preoperative superior vena caval (SVC) syndrome was present in seven patients. The most frequent diagnosis was a primary thoracic malignant neoplasm (10 patients). Reconstruction was performed with a pericardial tube in four patients, venae saphena magna in three patients, umbilical vein in three patients, and Dacron grafts in two patients. A temporary bypass was used in three patients. All the patients survived the operation. Eight patients died within 15 months of the surgery. Four patients are long-term survivors without signs of an SVC syndrome. Based on our experience and a review of the literature, we recommend the use of two autogenous vein grafts or a ringed polytetrafluoroethylene graft with a diameter of about one half that of the normal SVC to replace the large mediastinal veins.
Adult↗
A bronchoscopic brush biopsy study of large airway mucosal pathology in smokers with chronic bronchitis and in healthy nonsmokers.
We investigated the use of bronchial brush biopsies of the bronchial epithelium as a diagnostic tool in common airway diseases. Flexible fibreoptic bronchoscopy was performed on 22 smokers with nonobstructive chronic bronchitis and on 14 healthy nonsmoking individuals. Ten of the smokers had recurrent infectious exacerbations. Cell samples were taken from carinal and subsegmental levels of the bronchial tree with a standard cytological brush, and a differential count was made of the different cell types. Smokers with chronic bronchitis had significantly more goblet cells (mean 20.0, SD 8.6), and less ciliated epithelial cells (mean 74.1, SD 9.4), than the healthy nonsmokers (mean 9.2, SD 3.9 and mean 84.7, SD 6.6, respectively). No such changes were found between the chronic bronchitis groups with or without infectious exacerbations. Thus, bronchial brush biopsies can be used as a complement to standard bronchial biopsies in the investigation of airway diseases other than pulmonary malignancies.
Biopsy↗
The risk of lung cancer and mesothelioma after cessation of asbestos exposure: a prospective cohort study of shipyard workers.
A prospective cohort study of 3,893 shipyard workers, mainly exposed to chrysotile, indicated no increased risk of lung cancer 7-15 yrs after exposure to asbestos had ceased. The shipyard workers, however, had an increased risk of pleural mesotheliomas with 11 observed cases versus 1.5 expected. An explanation for these observations may be that asbestos may have different carcinogenic mechanisms in causing lung cancer and mesothelioma. A non-increased risk of lung cancer some years after exposure to asbestos has stopped is in accordance with asbestos acting as a promotor. The high risk of mesothelioma, on the other hand, may indicate that asbestos acts as a complete carcinogen in developing this disease.
Adult↗