| 1. |
- Cederbrant, Karin, et al.
(författare)
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In vitro Lymphoproliferative Assays with HgCl2 Cannot Identify Patients with Systemic Symptoms Attributed to Dental Amalgam
- 1999
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Ingår i: Journal of Dental Research. - : SAGE Publications. - 0022-0345 .- 1544-0591. ; 78:8, s. 1450-1458
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Tidskriftsartikel (refereegranskat)abstract
- Dental amalgam is suspected, by some exposed individuals, to cause various systemic psychological, sensory, and neurological symptoms. Since not all amalgam-bearers experience such reactions, an individual characteristic—for example, a susceptible immune system—might explain these conditions. In vitro lymphocyte proliferation is a valuable tool in the diagnosis of allergy. With HgCl2 as the antigen, however, the test is hampered, because Hg2+ can cause unspecific lymphocyte proliferation, optimal at 1.4 to 9.5 μg HgCl2/mL. Recently, the use of suboptimal HgCl2 concentrations (≤ 0.5 μg/mL) has been suggested to circumvent these problems. The main aim of this study was to investigate whether patients with systemic symptoms alleged to result from the presence of dental amalgam differ from healthy controls, with reference to in vitro lymphoproliferative responses to HgCl2 ≤ 0.5 μg/mL. Three different test protocols—lymphocyte transformation test (LTT) in micro- and macro-cultures, and the memory lymphocyte immunostimulation assay (MELISA®)—were used. Other immune parameters—such as a standard patch test for dental materials, the number of T- and B-lymphocytes, monocytes, granulocytes, and NK cells in peripheral blood, allergic symptoms, and predisposition-were also investigated. Twenty-three amalgam patients, 30 healthy blood donors with amalgam, ten healthy subjects without amalgam, and nine patients with oral lichen planus (OLP) adjacent to dental amalgam and a positive patch test to Hg0 were tested. None of the investigated immune parameters revealed any significant differences between amalgam patients and controls. The sensitivity of in vitro lymphocyte proliferation ranged from 33 to 67%, with the OLP patients as a positive control group, and the specificity from 0 to 70% for healthy controls with a negative patch test to Hg°. Thus, despite the use of HgCl2 ≤ 0.5 μg/mL, a high frequency of positive results was obtained among healthy subjects with or without dental amalgam. Consequently, in vitro lymphocyte proliferation with HgCl2 cannot be used as an objective marker for mercury allergy in dental amalgam-bearers.
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| 2. |
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| 3. |
- Fransson, Sven-Göran, 1949-, et al.
(författare)
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Radiologic Diagnosis of Gastro-Oesophageal Reflux
- 1989
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Ingår i: Acta Radiologica. - : Sage Publications. - 0284-1851 .- 1600-0455. ; 30:2, s. 187-192
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Tidskriftsartikel (refereegranskat)abstract
- In 149 patients, a standardized radiologic method for the detection of gastro-oesophageal reflux was applied and compared with the results obtained at endoscopy and by a manometric reflux test. Radiologic reflux was recorded in 53 patients, of whom 25 had reflux without abdominal compression and 51 with compression. At least one of the other two types of examination disclosed pathologic conditions in all but 2 of 53 patients. Oesophagitis was significantly more severe among the patients with reflux observed at radiography. The presence of hiatal incompetence with reflux only to the hiatal hernia but not to the oesophagus was not a strong indicator of gastro-oesophageal reflux disease. Hiatal hernia was present in a significantly larger number of the patients with reflux at radiography than in those without reflux. Increased width of the hiatus gave stronger evidence for reflux disease than in patients with a normal hiatus. Thus, the width of the hiatus also had a bearing on the diagnosis of gastro-oesophageal reflux disease.
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| 4. |
- Fransson, Sven-Göran, 1949-, et al.
(författare)
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Radiologic diagnosis of gastro-oesophageal reflux by means of graded abdominal compression
- 1988
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Ingår i: Acta Radiologica. - : Informa Healthcare. - 0284-1851 .- 1600-0455. ; 29:1, s. 45-48
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the study was to ascertain whether abdominal compression by a standardized technique increases the reliability of the radiologic diagnosis of gastro-oesophageal reflux. Eighty-eight patients were examined by means of a manometric reflux test, 24-hour measurements of pH and endoscopy. The radiologic examination was performed with and without graded abdominal compression, the patient at the same time turning from side to side. When abdominal compression was included the result of the radiologic examination was positive in 31 patients. In the absence of abdominal compression reflux was detected in 11 of these patients. In one patient reflux was detected only without compression. All these 31 patients had one more test positive and in 27 at least 2 more tests were positive. Another 21 patients had reflux disease as indicated by at least 2 of the 3 other tests. The compression technique seems to yield no false positive responses, and proved to be significantly more reliable than examinations without compression.
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| 5. |
- Fransson, Sven-Göran, 1949-, et al.
(författare)
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Radiologic Diagnosis of Gastro-Oesophageal Reflux - Comparison of barium and low-density contrast medium
- 1987
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Ingår i: Acta Radiologica. - : Informa Healthcare. - 0284-1851 .- 1600-0455. ; 28:3, s. 295-298
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Tidskriftsartikel (refereegranskat)abstract
- It has been proposed that the high density of ordinary barium suspensions may complicate the radiologic diagnosis of gastro-oesophageal reflux. For this reason P-contrast was developed (Ferring AB); a contrast medium with the same density as water (1 g/cm3). A comparison of P-contrast and barium (Mixobar Ventrikel 400 mg/ml) was performed in 82 patients. All patients were examined with both contrast media and the findings were compared with those at reflux test at manometry, endoscopy and 24-hour pH monitoring. Another 40 patients and 15 symptom-free controls were examined with two different amounts of barium, 100 ml and 200 ml, to study if the radiologic diagnosis of reflux varied with the volume of contrast medium administered. P-contrast was found to have no advantages over barium for the diagnosis of gastro-oesophageal reflux. The outcome of the radiologic examination was not influenced by the different volumes of barium used.
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| 6. |
- Fransson, Sven-Göran, 1949-, et al.
(författare)
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Radiologic findings after fundoplication compared with a pH reflux test and symptoms
- 1986
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Ingår i: Acta Radiologica. - : Sage Publications. - 0284-1851 .- 1600-0455. ; 27:1, s. 33-39
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Tidskriftsartikel (refereegranskat)abstract
- In a follow-up after fundoplication, 61 patients underwent a double contrast examination of the stomach and a radiologic examination to detect any gastro-oesophageal reflux. The radiologic findings were compared with pH reflux test and symptoms. Gastro-oesophageal reflux was found in 7 patients at radiologic examination. None of these patients had an adequate fundoplication at a double contrast examination of the stomach and all had symptoms indicating reflux. Recurrence of gastro-oesophageal reflux may be shown at the radiologic examination and predicted by the morphologic appearances at the double contrast examination.
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| 7. |
- Gustafsson, P. M., et al.
(författare)
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Gastro-oesophageal reflux and severity of pulmonary disease in cystic fibrosis
- 1991
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Ingår i: Scandinavian Journal of Gastroenterology. - : Informa Healthcare. - 0036-5521 .- 1502-7708. ; 26:5, s. 449-456
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Tidskriftsartikel (refereegranskat)abstract
- The correlation between oesophageal dysfunction (OD), pathologic gastro-oesophageal reflux (GOR), and severity of pulmonary disease was studied in 12 patients with cystic fibrosis (CF). They were interviewed about symptoms of OD and underwent 24-h pH recording in the oesophagus, oesophageal manometry combined with reflux provocation tests, the acid perfusion test, the acid clearance test, lung function tests, and scoring of the chest radiograph. Six of the 12 patients reported symptoms of OD. Abnormal GOR, as shown by 24-h pH monitoring of the oesophagus, was found in eight of them. Altogether 9 of the 12 participants had at least one pathologic oesophagus test result. Results of radiologic examinations of the oesophagus, performed in six patients, were pathologic. The four patients with the best chest radiograph scores and the best lung function had significantly less signs and symptoms of OD and GOR than the other eight patients. We conclude that OD, GOR, and pulmonary disease covariate in CF.
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| 8. |
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| 9. |
- Johansson, K. E., et al.
(författare)
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Oesophageal reflux tests, manometry, endoscopy, biopsy, and radiology in healthy subjects
- 1986
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Ingår i: Scandinavian Journal of Gastroenterology. - : Informa Healthcare. - 0036-5521 .- 1502-7708. ; 21:4, s. 399-406
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Tidskriftsartikel (refereegranskat)abstract
- The aim was to study the exposure time of acid during 24 h at two different oesophageal levels in 15 healthy subjects and its relation to other kinds of oesophageal findings. Five centimetres above the lower oesophageal sphincter the total reflux time was 0.2% (0-1.3%), and at the 15-cm level it was 0.1% (0-0.7%). A standardized compression test during manometry and radiologic examination showed that no subject had reflux. Hiatus hernia was provoked at the radiologic examination in four subjects, one of whom also had a widened hiatus. At endoscopy, one subject had a hiatus hernia and slightly granulated oesophageal mucosa. Biopsy specimens showed slight basal cell hyperplasia in one case. Bleeding in the dermal papillae or a few intraepithelial leukocytes were seen in eight cases, findings that might be due to endoscopic trauma. Without any history of gastrointestinal disorders, gastrooesophageal reflux was minimal under standardized conditions, although hiatus hernia and mild changes in biopsy specimens could be seen.
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| 10. |
- Johansson, K. E., et al.
(författare)
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Oesophagitis, signs of reflux, and gastric acid secretion in patients with symptoms of gastro-oesophageal reflux disease
- 1986
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Ingår i: Scandinavian Journal of Gastroenterology. - Oslo : Informa Healthcare. - 0036-5521 .- 1502-7708. ; 21:7, s. 837-847
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Tidskriftsartikel (refereegranskat)abstract
- In a study comprising 100 patients referred to a surgical clinic with symptoms suggestive of gastro-oesophageal reflux disease the value of different diagnostic procedures was investigated. Positive acid perfusion and 24-h pH tests were the commonest findings. Forty-nine per cent showed a normal oesophageal mucosa or diffuse oesophagitis at endoscopy. The severity of heartburn and regurgitation did not differ between patients with normal oesophageal mucosa and oesophagitis of various severities. The severity of macroscopic oesophagitis was significantly correlated to the total reflux time, the presence of reflux or a hiatal hernia at radiology, an open cardia or reflux at endoscopy, pressure transmission or reflux and low lower oesophageal sphincter pressure at manometry. Gastric hypersecretion was found in 66% of the patients. Gastric acid secretion was not correlated to the severity of oesophagitis or to the findings at 24-h pH test. In patients with severe oesophagitis the sensitivity for radiologic, manometric, and endoscopic signs of incompetence of the gastro-oesophageal junction was 94%.
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