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| 2. |
- Almroth, Gabriel, 1953-, et al.
(författare)
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Detection and prevention of hepatitis C in dialysis patients and renal transplant recipients : A long-term follow up (1989–January 1997)
- 2002
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Ingår i: Journal of Internal Medicine. - : Wiley. - 0954-6820 .- 1365-2796. ; 251:2, s. 119-128
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Tidskriftsartikel (refereegranskat)abstract
- Background. Hepatitis C is frequent problem in dialysis wards.Design. A long time (1989–97) follow up of hepatitis C virus (HCV) infection in a Swedish nephrology unit was performed with anti-HCV screening, confirmatory antibody tests, viral RNA detection and molecular characterization. Case histories were reviewed with focus, onset of infection, liver morbidity and mortality.Results. In October 1991, 10% (19 of 184) of the patients in the unit (haemodialysis-, peritoneal dialysis and transplanted patients) were verified or suspected HCV carriers, whilst the number at the end of 1996 was 8% (13 of 157). Most patients were infected before 1991 but only in one case from a known HCV-infected blood donor. No new HCV infections associated with haemodialysis occurred during the study period. A total of 13 of 24 viremic patients had HCV genotype 2b, a pattern suggesting nosocomial transmission. This was further supported by phylogenetic analysis of HCV viral isolates in seven. HCV viremia was also common in patients with an incomplete anti-HCV antibody pattern as 8 of the 12 indeterminant sera were HCV-RNA positive.Conclusions. Awareness, prevention, identification of infected patients and donor testing limited transmission. Indeterminant recombinant immunoblot assays (RIBA)-results should be regarded with caution as a result of the relative immunodeficiency in uremic patients. Our data indicate nosocomial transmission in several patients.
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| 3. |
- Björkman, Anders, et al.
(författare)
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Factor V leiden and prothrombin gene mutation: risk factors for osteonecrosis of the femoral head in adults.
- 2004
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Ingår i: Clinical Orthopaedics and Related Research. - 0009-921X. ; :425, s. 168-172
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of the current study was to determine whether factor V Leiden and the prothrombin 20210A gene mutation are risk factors for osteonecrosis of the femoral head in different etiologic groups of osteonecrosis in adults and whether patients with idiopathic osteonecrosis of the femoral head have a higher frequency of thromboembolic events compared with the general population. We investigated 63 adult patients with nontraumatic osteonecrosis of the femoral head for etiologic factors, such as corticosteroid medication and alcohol abuse, and the occurrence of factor V Leiden and the prothrombin 20210A gene mutation. In 35 patients, the disease was considered idiopathic and 10 of these patients (29%) had factor V Leiden or the prothrombin 20210A gene mutation or both. Mutations in factor V or the prothrombin 20210A gene were significantly more frequent in patients with idiopathic osteonecrosis than in a population of healthy control subjects (odds ratio, 2.7; 95% confidence interval range, 1.2-5.8) and in patients with osteonecrosis caused by corticosteroid medication or alcohol abuse (odds ratio, 10.8; 95% confidence interval range, 1.4-84). 36% of patients with a gene mutation had had a thromboembolic event compared with 8% of patients without a gene mutation. Thromboembolic events were more common among patients with idiopathic osteonecrosis (17%) compared with the general population (4%) and with patients with osteonecrosis caused by corticosteroid medication or alcohol abuse (7%).
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| 4. |
- Ihse, Ingemar, et al.
(författare)
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Riktlinjer för handläggning av patienter med pankreascancer
- 2002
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Ingår i: Läkartidningen. - 0023-7205. ; 99:15, s. 1676-1683
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Tidskriftsartikel (refereegranskat)abstract
- The incidence of pancreatic cancer has fallen during the last ten years in Sweden. Early signs and symptoms of the disease are still undiscovered and when diagnosis is made the disease is incurable in most patients. Transabdominal ultrasonography is the first-line imaging test followed by spiral computed tomography (CT) and magnetic resonance imaging (MRI) if required for definite diagnosis. Spiral CT is also the imaging test of choice for assessment of resectability of the tumor. Surgical removal of the tumor is the only chance of cure. Markedly improved hospital mortality after pancreaticoduodenectomy is reported and an association between hospital volume and outcome of the operation has been established. Longterm survival after attempted curative resection continues to be dismal, however. Adjuvant treatment should not be given outside clinical studies. Palliative treatment has improved thanks to progress in the field of endoscopy, interventional radiology and in management of pain and nutrition. Palliative chemotherapy should only be given selectively outside clinical studies. Radiotherapy has no proven effects on survival. Special pancreatic cancer treatment teams with catchment areas of 2-4 million inhabitants are recommended by international authorities.
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| 5. |
- Ihse, Ingemar, et al.
(författare)
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Riktlinjer för handläggning av patienter med pankreascancer [Guidelines for management of patients with pancreatic cancer]
- 2002
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Ingår i: Läkartidningen. - 0023-7205 .- 1652-7518. ; 99:15, s. 1676-1685
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Transabdominellt ultraljud är förstahandsundersökning vid misstänkt pankreascancer, följt av spiral-DT eller MR för mer definitiv diagnos. Tumörmarkörer har ingen plats i rutindiagnostiken. Spiral-DT är basen i resektabilitetsbedömningen. Resektion av tumören är en förutsättning för bot. Ett samband har påvisats mellan antalet resektioner som görs vid ett sjukhus årligen och postoperativ mortalitet. Långtidsöverlevnaden efter resektion är oförändrat kort medan postoperativ mortalitet minskat dramatiskt vid enheter som rapporterat sina resultat. Adjuvant behandling efter resektion bör endast ges inom ramen för kliniska studier. Det palliativa omhändertagandet har förbättrats främst genom utveckling inom endoskopi, interventionell radiologi, smärt- och nutritionsbehandling. Palliativ cytostatikabehandling bör endast ges selektivt utanför kliniska studier. Radioterapi har ingen dokumenterad effekt på överlevnaden vid icke-resektabel pankreascancer. Internationellt rekommenderas speciella behandlingsteam för pankreascancer med tillräckliga upptagningsområden (2–4 miljoner invånare).
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| 6. |
- Petersson, Karin, et al.
(författare)
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Crystal structure of a superantigen bound to MHC class II displays zinc and peptide dependence
- 2001
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Ingår i: EMBO Journal. - : Wiley. - 0261-4189 .- 1460-2075. ; 20:13, s. 3306-3312
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Tidskriftsartikel (refereegranskat)abstract
- The three-dimensional structure of a bacterial superantigen, Staphylococcus aureus enterotoxin H (SEH), bound to human major histocompatibility complex (MHC) class II (HLA-DR1) has been determined by X-ray crystallography to 2.6 Å resolution (1HXY). The superantigen binds on top of HLA-DR1 in a completely different way from earlier co-crystallized superantigens from S. aureus. SEH interacts with high affinity through a zinc ion with the β1 chain of HLA-DR1 and also with the peptide presented by HLA-DR1. The structure suggests that all superantigens interacting with MHC class II in a zinc-dependent manner present the superantigen in a common way. This suggests a new model for ternary complex formation with the T-cell receptor (TCR), in which a contact between the TCR and the MHC class II is unlikely.
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| 7. |
- Svensson, Per Anders, 1959, et al.
(författare)
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Identification of genes predominantly expressed in human macrophages
- 2004
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Ingår i: Atherosclerosis. - : Elsevier BV. ; 177, s. 287-290
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Tidskriftsartikel (refereegranskat)abstract
- Identification of cell and tissue specific genes may provide novel insights to signaling systems and functions. Macrophages play a key role in many diseases including atherosclerosis. Using DNA microarrays we compared the expression of approximately 10,000 genes in 56 human tissues and identified 23 genes with predominant expression in macrophages. The identified genes include both genes known to be macrophage specific and genes previously not well described in this cell type. Tissue distribution of two genes, liver X receptor (LXR) alpha and interleukin-1 receptor antagonist (IL1RN), was verified by real-time RT-PCR. We conclude that comparison of expression profiles from a large number of tissues can be used to identify genes that are predominantly expressed in certain tissues. Identification of novel macrophage specific genes may increase our understanding of the role of this cell in different diseases.
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| 8. |
- Valdemarsson, Stig, et al.
(författare)
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Evaluation of surgery for acromegaly: role of intraoperative growth hormone measurement?
- 2001
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Ingår i: Scandinavian Journal of Clinical & Laboratory Investigation. - : Informa UK Limited. - 1502-7686 .- 0036-5513. ; 61:6, s. 459-470
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Intraoperative growth hormone (GH ) measurement has earlier been tried to improve surgery for acromegaly. We calculated GH half-life after adenomectomy and evaluated the possible role of this variable in predicting the final outcome of pituitary surgery in 28 consecutive patients with acromegaly. The sensitivity, specificity and predictive values were determined in relation to the results from GH suppression during an oral glucose load and IGF-1 3 months postoperatively. The GH half-life data were also compared to the corresponding results obtained from GH measurements between 60 min and 180 min after adenomectomy, and early, within 1 week, postoperatively. RESULTS: GH half-life < or =31 min was recorded in 8/13 cured patients but also in 2/15 unsuccessful cases. A mean GH concentration < or =4.4 mU/L between 60 min and 120 min after adenomectomy was found in 11/13 cured subjects but also in 3/15 not cured patients. A mean GH < or =4.0 mU/L between 90 min and 180 min was found in 11/13 cured and in 4/15 not cured patients. A mean early postoperative GH concentration < or =2.6 mU/L was noted in all 13 cured patients, but also in 2/13 unsuccessful cases. The specificity of early postoperative GH < or = 2.6 mU/L was 100% compared to 62% for a GH half-life < or =31 min (p<0.05) and 85% for the GH mean values between 60 min and 120 min and 90 min and 180 min, respectively. The sensitivity for persistent disease of values above the four cut-off limits used was between 73% and 87%. The positive predictive value for a mean early postoperative GH value >2.6 mU/L was 100%, and 72% for a GH half-life >31 min (n.s.). CONCLUSION: Although intraoperative GH half-life might be useful in some cases, it was not a reliable tool for predicting outcome of pituitary surgery in acromegaly. In cases with a 51% decrease of a basal GH concentration >5.5 mU/L, mean GH values < or =4 to < or =4.4 mU/L late intraoperatively were more informative but not as good as those obtained from the mean of a series of GH values drawn on one occasion within 1 week postoperatively, offering a 100% specificity for cure if < or =2.6 mU/L. Intraoperative GH half-life measurements should therefore be used with caution. The predictive values of the cut-off limits used in this study should be further evaluated before general application.
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| 9. |
- Aberg, D., et al.
(författare)
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Nitrogen deactivation by implantation-induced defects in 4H-SiC epitaxial layers
- 2001
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Ingår i: Applied Physics Letters. - : AIP Publishing. - 0003-6951 .- 1077-3118. ; 78:19, s. 2908-2910
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Tidskriftsartikel (refereegranskat)abstract
- Ion implantation causes free charge carrier reduction due to damage in the crystalline structure. Here, nitrogen-doped 4H silicon carbide (n type) epitaxial layers have been investigated using low ion doses in order to resolve the initial stage of the charge carrier reduction. It was found that the reduction of free carriers per ion-induced vacancy increases with increasing nitrogen content. Nitrogen is suggested to be deactivated through reaction with migrating point defects, and silicon vacancies or alternatively interstitials are proposed as the most likely candidates.
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| 10. |
- Aberg, D., et al.
(författare)
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Nitrogen passivation by implantation-induced point defects in 4H-SiC epitaxial layers
- 2001
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Ingår i: Applied Surface Science. - 0169-4332 .- 1873-5584. ; 184:04-jan, s. 263-267
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Tidskriftsartikel (refereegranskat)abstract
- Ion implantation causes damage to the crystal lattice resulting in the loss of free charge carriers. In this study, low dose implantations using different ions and implantation doses are made to resolve the initial carrier loss in nitrogen-doped epitaxial layers. A strong dependence of compensation on nitrogen concentration is seen, showing that nitrogen is passivated by implantation-induced point defects. An activation energy of 3.2 eV for the dissociation of the passivated nitrogen center is obtained.
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